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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