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Individual

MR. JEREMY C. VINCENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A., PLPC

Contact information

Practice address
2053 S WAVERLY AVE STE D, SPRINGFIELD, MO 65804-2497
(417) 866-8262
(417) 886-8109
Mailing address
2053 S WAVERLY AVE STE D, SPRINGFIELD, MO 65804-2497
(417) 866-8262
(417) 886-8109

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2010039182
MO

Other

Enumeration date
11/19/2010
Last updated
11/29/2010
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