Individual
MRS. JACQUELINE PEPPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1007 N COLLEGE AVE, ST. 1, COLUMBIA, MO 65201-4794
(573) 214-2253
(573) 474-5683
Mailing address
1007 N COLLEGE AVE, ST. 1, COLUMBIA, MO 65201-4794
(573) 214-2253
(573) 474-5683
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW005246
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24647036
BC/BS PROVIDER NUMBER
MO
05
—
498301332
—
MO
05
—
753424407
—
MO
Enumeration date
08/30/2005
Last updated
07/12/2011
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