Individual
MR. DALE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
2501A W ASH ST, COLUMBIA, MO 65203-4609
(573) 529-3439
Mailing address
2501A W ASH ST, COLUMBIA, MO 65203-4609
(573) 529-3439
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001494
MO
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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