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Individual

MRS. LORI RENEE RADFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PLPC

Contact information

Practice address
1041 E WALNUT ST, SPRINGFIELD, MO 65806-2604
(417) 459-2117
Mailing address
3379 STATE HIGHWAY O, HIGHLANDVILLE, MO 65669-8172
(417) 434-5105

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
2012040744
MO
101YA0400X
Addiction (Substance Use Disorder) Counselor
2012040744
MO
101YM0800X
Mental Health Counselor
Primary
2012040744
MO
101YP2500X
Professional Counselor
2012040744
MO

Other

Enumeration date
01/04/2013
Last updated
01/04/2013
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