Individual
DR. JACKIE L DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LP
Contact information
Practice address
2885 W BATTLEFIELD ST, SPRINGFIELD, MO 65807-3952
(417) 761-5000
Mailing address
PO BOX 844715, KANSAS CITY, MO 64184-4715
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2007015262
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498802818
—
MO
Enumeration date
06/19/2007
Last updated
05/14/2025
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