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Individual

LINDA E MADDOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3263 E LOMBARD ST, SPRINGFIELD, MO 65802
(417) 860-3705
Mailing address
440 S MARKET AVE, SPRINGFIELD, MO 65806
(417) 860-3705

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004853
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
498493907
MO
Enumeration date
04/25/2008
Last updated
04/25/2008
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