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Individual

ALLICIA D BAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD, LP

Contact information

Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 269-5400
(417) 269-7212
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 269-5400
(417) 269-7212

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2004033753
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
498443803
MO
Enumeration date
06/23/2005
Last updated
04/10/2026
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