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Organization
FATINO COUNSELING, LLC
Active
Organization
FATINO COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY DRAKE (OFFICE MANAGER)
(417) 766-8090
Entity
Organization
Contact information
Practice address
1901 WOMMACK AVE, BOLIVAR, MO 65613-3128
(417) 766-8090
(417) 777-7017
Mailing address
PO BOX 967, BOLIVAR, MO 65613-0967
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2274
MO
Other
Enumeration date
07/18/2017
Last updated
07/18/2017
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