Individual
MRS. CONNIE JEAN ALSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRADAC
Contact information
Practice address
301 WARRIOR LANE, POPLAR BLUFF, MO 63902
(573) 686-1200
(573) 686-1029
Mailing address
301 WARRIOR LANE, POPLAR BLUFF, MO 63902
(573) 686-1200
(573) 686-1029
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4835
MO
101YA0400X
Addiction (Substance Use Disorder) Counselor
920
MO
Other
Enumeration date
03/30/2011
Last updated
03/30/2011
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