Individual
DR. LORETTA FUGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
827 W COMMERCIAL ST, MANSFIELD, MO 65704-9520
(417) 924-8188
(417) 924-8190
Mailing address
827 W. COMMERCIAL, P.O. BOX 47, MANSFIELD, MO 65704-0677
(417) 924-8188
(417) 924-8190
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2005028862
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285906107
CORNERSTONE PSYCHOLOGICAL SERVICES
MO
01
—
1366779100
GROUP PRACTICE
MO
01
—
218034
BLUE CROSS BLUE SHIELD
MO
05
—
498979111
—
MO
Enumeration date
08/18/2006
Last updated
03/24/2012
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