Individual
JEANIE DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1353 N MOUNT AUBURN RD, SUITE C, CAPE GIRARDEAU, MO 63701-1727
(573) 803-1402
Mailing address
2909 INDEPENDENCE ST, CAPE GIRARDEAU, MO 63703-5044
(573) 803-1402
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002485
MO
Other
Enumeration date
03/01/2011
Last updated
03/15/2013
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