Individual
MARISSA L FORT-CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LPC
Contact information
Practice address
1328 W BROADWAY ST STE 2, WEBB CITY, MO 64870-1620
(417) 719-1407
Mailing address
2712 E SADIE CT, JOPLIN, MO 64801-4821
(417) 621-5575
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2023005080
MO
Other
Enumeration date
01/07/2025
Last updated
01/07/2025
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