Organization
LIFESONG FOR GROWTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH MIDDLETON MA, LCSW (PARTNER)
(573) 644-7909
Entity
Organization
Contact information
Practice address
3401 W TRUMAN BLVD, STE 100, JEFFERSON CITY, MO 65109-5752
(573) 644-7909
(573) 644-7908
Mailing address
3401 W TRUMAN BLVD, STE 100, JEFFERSON CITY, MO 65109-5752
(573) 644-7909
(573) 644-7908
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
11/04/2010
Last updated
05/02/2014
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