Individual
MR. LESLIE D MOONEYHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LPC
Contact information
Practice address
RR 2 BOX 2711, WHEATLAND, MO 65779-9809
(573) 298-1786
(888) 301-6832
Mailing address
RR 2 BOX 2711, WHEATLAND, MO 65779-9809
(573) 298-1786
(888) 301-6832
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2005024749
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497430108
—
MO
05
—
497430116
—
MO
05
—
497430124
—
MO
Enumeration date
09/29/2006
Last updated
04/22/2008
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