Organization
GREATER OZARKS RURAL PSYCHOLOGISTS LLC
Active
Organization
GREATER OZARKS RURAL PSYCHOLOGISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORETTA S. FUGE PSY.D. (PSYCHOLOGIST)
(417) 924-8188
Entity
Organization
Contact information
Practice address
827 W COMMERCIAL ST, MANSFIELD, MO 65704-9520
(417) 924-8188
(417) 924-8188
Mailing address
827 W COMMERCIAL ST, P.O. BOX 47, MANSFIELD, MO 65704-9520
(417) 924-8188
(417) 924-8188
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2005028862
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316196215
NPI
MO
Enumeration date
11/16/2009
Last updated
12/14/2009
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