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Organization

NEW WAY PSYCHOLOGICAL SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES J WILSON LPC (MEMBER)
(417) 399-1793
Entity
Organization

Contact information

Practice address
711 N MARKET AVE, BOLIVAR, MO 65613-1114
(417) 399-1793
Mailing address
711 N MARKET AVE, BOLIVAR, MO 65613-1114
(417) 399-1793

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101YP2500X
MO
Enumeration date
07/01/2019
Last updated
01/19/2021
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