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Individual

MR. MARK MCDONALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, CSACII, CCGC

Contact information

Practice address
305 S VIRGINIA AVE, JOPLIN, MO 64801-2323
(417) 347-7730
Mailing address
3012 KENTUCKY AVE, JOPLIN, MO 64804-2745

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2805
MO
251B00000X
Case Management Agency
2805
MO

Other

Enumeration date
03/07/2007
Last updated
05/11/2010
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