Organization
KATIE COMMUNITY HEALTH CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA DEWITT LCSW (OWNER)
(417) 299-0753
Entity
Organization
Contact information
Practice address
143 MILL STREET, RAYMONDVILLE, MO 65555
(417) 299-0753
Mailing address
630 S NEWTON AVE, SPRINGFIELD, MO 65806-2742
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2003003711
MO
Other
Enumeration date
05/05/2010
Last updated
05/05/2010
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