Individual
MISS BETTY ANN CAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
131 ST. THOMAS LANE, NEW MADRID, MO 63869
(573) 748-9438
Mailing address
131 ST. THOMAS LANE, NEW MADRID, MO 63869
(573) 748-9438
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2606 10125
MO
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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