Individual
BELINDA MAE LICEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1051 KINGSHIGHWAY ST STE 5, ROLLA, MO 65401-2981
(573) 364-8511
Mailing address
PO BOX 459, FARMINGTON, MO 63640-0459
(573) 756-5749
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
21619189
MO
101YP2500X
Professional Counselor
Primary
2016019189
MO
Other
Enumeration date
10/24/2017
Last updated
04/19/2026
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