Individual
JACOB BRADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PLPC
Contact information
Practice address
1771 S FREMONT AVE, SPRINGFIELD, MO 65804-1151
(427) 597-4881
Mailing address
1740 SOUTH AVE, SPRINGFIELD, MO 65807-2013
(541) 650-1485
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2024006573
MO
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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