Individual
DR. CRYSTAL STACK LIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
ONE HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-1561
(573) 884-1889
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
2022015232
MO
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2022015232
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05908053
—
MS
05
—
490113666
—
MO
Enumeration date
09/29/2011
Last updated
04/10/2024
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