Individual
ELIZABETH M DARDENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
3101 S KIMBROUGH AVE, SUITE C, SPRINGFIELD, MO 65807-5011
(417) 866-7773
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2016032967
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13965071
CAQH
MO
05
—
490036039
—
MO
Enumeration date
09/22/2016
Last updated
01/08/2024
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