Individual
DR. MICHAEL DAVID RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D, LCPC, CRADC
Contact information
Practice address
12496 OLD 79, NEW LONDON, MO 63459-2741
(573) 248-2051
(573) 248-2051
Mailing address
12496 OLD 79, NEW LONDON, MO 63459-2741
(573) 248-2051
(573) 248-2051
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001395
MO
101YP2500X
Professional Counselor
180.002197
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498873918
—
MO
Enumeration date
10/16/2007
Last updated
07/08/2011
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