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Individual

MR. GABRIEL NICHOLAS LETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LPC

Contact information

Practice address
614 S WALL AVE, JOPLIN, MO 64801-2526
(417) 624-4833
Mailing address
409 MORGAN CT, JOPLIN, MO 64801-1590
(417) 529-2943

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
2004014990
MO
101YM0800X
Mental Health Counselor
2004014990
MO
101YP2500X
Professional Counselor
Primary
2004014990
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1376612382
MO
Enumeration date
11/06/2006
Last updated
05/08/2013
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