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Individual

VICTORIA MARY INCRIVAGLIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.C.S.W.

Contact information

Practice address
2200 E SUNSHINE ST, STE 201, SPRINGFIELD, MO 65804-1819
(417) 823-0498
(417) 889-5289
Mailing address
2200 E SUNSHINE ST, STE 201, SPRINGFIELD, MO 65804-1819
(417) 823-0498
(417) 889-5289

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
SW002668
MO
251S00000X
Community/Behavioral Health Agency
Primary
SW002668
MO

Other

Enumeration date
09/29/2006
Last updated
01/02/2008
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