Individual
RANDEE JO FECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
575B BLUES LAKE PKWY, ROLLA, MO 65401-8587
(573) 364-2007
Mailing address
1050 W 10TH ST, ATTN: EXECUTIVE DIRECTOR OF PHYSICIAN CLINICS, ROLLA, MO 65401
(573) 364-9000
(573) 426-2108
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2004024852
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499346302
—
MO
Enumeration date
03/06/2007
Last updated
08/22/2019
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