Organization
JENNIFER C. BOUWKAMP-MEMMER, PHD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER C. BOUWKAMP-MEMMER PHD (SOLE MEMBER/LICENSED PSYCHOLOGIST)
(573) 356-5045
Entity
Organization
Contact information
Practice address
5209 MEXICO GRAVEL RD, COLUMBIA, MO 65202-6915
(573) 356-5045
Mailing address
5209 MEXICO GRAVEL RD, COLUMBIA, MO 65202-6915
(573) 356-5045
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2008034834
MO
Other
Enumeration date
11/02/2009
Last updated
11/02/2009
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