Individual
NEAL EVAN DESHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, LPC
Contact information
Practice address
440 S MARKET AVE, SPRINGFIELD, MO 65806-2026
(573) 821-3513
Mailing address
1624 S RAFORD DR, SPRINGFIELD, MO 65809-2336
(573) 821-3513
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2004014921
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14407460
CAQH
MO
Enumeration date
02/22/2019
Last updated
08/18/2022
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