Individual
LISA DENINE PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1652 N BUSINESS ROUTE 5, CAMDENTON, MO 65020
(573) 302-7490
Mailing address
PO BOX 777, RICHLAND, MO 65556-0777
(573) 535-5030
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2018032484
MO
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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