Individual
DR. KEITH ALLEN VUNESKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2200 E SUNSHINE ST, SUITE 312, SPRINGFIELD, MO 65804-1819
(417) 881-3759
(417) 881-7004
Mailing address
807 S PINHOOK DR, NIXA, MO 65714-8030
(417) 724-1366
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2006029922
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R88F227
DOMHA MCR MISS PTAN
MO
Enumeration date
10/17/2006
Last updated
04/01/2008
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