Individual
MRS. CARRIE EIZENGA DANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1221 BROADWAY, HANNIBAL, MO 63401-4005
(573) 221-2111
(573) 221-2597
Mailing address
10299 TANGLEWOOD LN, HANNIBAL, MO 63401-7453
(573) 221-2111
(573) 221-2597
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2004013377
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498318625
—
MO
Enumeration date
10/06/2006
Last updated
06/30/2021
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