Individual
MRS. MARY JANE PATTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12948 HIGHWAY 53, QULIN, MO 63961-8260
(573) 328-4026
(573) 328-4883
Mailing address
12948 HIGHWAY 53, QULIN, MO 63961-8260
(573) 328-4026
(573) 328-4883
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
03/15/2007
Last updated
09/11/2025
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