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Individual

PEGGY LYNN THOENEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED., LPC

Contact information

Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2016035718
MO
101YP2500X
Professional Counselor
Primary
2016035718
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13942527
CAQH
Enumeration date
11/06/2017
Last updated
09/21/2021
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