Individual
MARK A KASSEBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1091 MIDWAY DR, LINN CREEK, MO 65052-1687
(573) 346-6758
(573) 346-0621
Mailing address
1091 MIDWAY DR, LINN CREEK, MO 65052-1687
(573) 346-6758
(573) 346-0621
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2007004366
MO
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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