Individual
MRS. HOLLY ANN DEWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
RR 2 BOX 2430B, BIRCH TREE, MO 65438-9222
(573) 292-1222
Mailing address
RR 2 BOX 2430B, BIRCH TREE, MO 65438-9222
(573) 292-1222
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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