Organization
WHOLE AND BALANCED THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA ANN ANDERSON PSY.D. (OWNER)
(417) 777-5314
Entity
Organization
Contact information
Practice address
1459 E BROADWAY ST, BOLIVAR, MO 65613-2950
(417) 777-5314
(417) 777-5320
Mailing address
PO BOX 347, BOLIVAR, MO 65613-0347
(417) 777-5314
(417) 777-5320
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
2005038008
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504593609
—
MO
Enumeration date
05/05/2006
Last updated
02/22/2018
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