Individual
MRS. BRANDYLYN S BRISTOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
708 EAST HIGHWAY 28, OWENSVILLE, MO 65066
(573) 486-1193
(573) 486-0910
Mailing address
2591 FOWLER ROAD, HERMANN, MO 65041
(573) 943-9973
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20080000932
MO
Other
Enumeration date
09/30/2010
Last updated
02/20/2012
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