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Individual

DR. CRAIG F BOUGHTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
440 S MARKET AVE, SPRINGFIELD, MO 65806-2026
(417) 844-9119
Mailing address
3204 W BROADMOOR ST, SPRINGFIELD, MO 65807-3190
(417) 844-9119

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2719
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
494634827
MO
Enumeration date
02/15/2007
Last updated
07/08/2022
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