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Individual

MR. KEITH CLOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PLPC

Contact information

Practice address
2021 S WAVERLY AVE STE 500, SPRINGFIELD, MO 65804-2400
(417) 597-4572
(314) 594-5503
Mailing address
2021 S WAVERLY AVE STE 500, SPRINGFIELD, MO 65804-2400
(417) 597-4572
(314) 594-5503

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2011004957
MO

Other

Enumeration date
03/02/2011
Last updated
03/02/2011
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