Individual
LAURA E FASO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
214 S NEOSHO BLVD, SUITE C-1, NEOSHO, MO 64850-1646
(417) 592-9415
Mailing address
214 S NEOSHO BLVD, SUITE C-1, NEOSHO, MO 64850-1646
(417) 592-9415
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW00543
MO
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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