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Individual

MISS MARY BETH HALDEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3001 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
(573) 686-1200
(573) 686-1029
Mailing address
PO BOX 280, POPLAR BLUFF, MO 63902-0280
(573) 686-1200
(573) 686-1029

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2007002228
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11792021
CAQH
01
2651
EAP IMPACT
05
494914906
MO
Enumeration date
03/07/2007
Last updated
03/12/2009
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