Organization
CLEAR WATER THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA SIDWELL LPC (OWNER)
(303) 704-1967
Entity
Organization
Contact information
Practice address
1202 HOMELIFE PLZ, ROLLA, MO 65401-2512
(573) 308-1540
Mailing address
1310 HILLVIEW DR, ROLLA, MO 65401-2549
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/07/2019
Last updated
11/18/2024
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