Individual
CASSANDRA LYNNE MINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
2148 W CHESTERFIELD BLVD STE E205, SPRINGFIELD, MO 65807-8650
(417) 708-7909
Mailing address
2148 W CHESTERFIELD BLVD STE E205, SPRINGFIELD, MO 65807-8650
(417) 708-7909
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2018013556
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490053654
—
MO
Enumeration date
04/25/2018
Last updated
02/15/2024
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