Individual
JOANIE M DEFIBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
107 E HARRISON ST, BRUNSWICK, MO 65236-1267
(573) 548-3033
Mailing address
PO BOX 69, SALISBURY, MO 65281-0069
(573) 548-3033
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2005027682
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497481705
—
MO
Enumeration date
12/22/2006
Last updated
01/31/2022
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