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Individual

ANGELA MARIE PEMBERTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED

Contact information

Practice address
701 W HIGH ST, JEFFERSON CITY, MO 65101-1525
(573) 659-1130
Mailing address
1515 S OAKS DR, JEFFERSON CITY, MO 65101-9079
(573) 659-1130

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
201203511
MO

Other

Enumeration date
10/11/2012
Last updated
10/11/2012
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