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1910 Greenwood Dr Ste D Poplar Bluff MO 63901-2430 | |
| (573) 718-8897 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1910 Greenwood Dr Ste D, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Stacey E. Bruce (LCSW) |
| Authorized Official Contact | 5737188897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5205 Crabapple Ln Poplar Bluff MO 63901-8524 Ph: (573) 718-8897 | 1910 Greenwood Dr Ste D Poplar Bluff MO 63901-2430 Ph: (573) 718-8897 |
| NPI Number | 1710482666 |
|---|---|
| Provider Enumeration Date | 03/23/2018 |
| Last Update Date | 03/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710482666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2010001438 (Missouri) | Primary |
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