Organization
CULTIVATING WELLNESS
Active
Organization
CULTIVATING WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA K COULTER LCSW (THERAPIST)
(417) 766-5566
Entity
Organization
Contact information
Practice address
227 E SUNSHINE ST, SPRINGFIELD, MO 65807-2652
(417) 709-4909
(417) 709-4909
Mailing address
227 E SUNSHINE ST STE 112, SPRINGFIELD, MO 65807-2630
(417) 709-4909
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235135153
BLUE CROSS BLUE SHIELD
MO
Enumeration date
05/20/2019
Last updated
05/20/2019
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