Individual
JESSICA MARIE NEWTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, PLPC
Contact information
Practice address
1202 HOMELIFE PLZ, ROLLA, MO 65401-2512
(573) 308-1540
Mailing address
1202 HOMELIFE PLZ, ROLLA, MO 65401-2512
(573) 308-1540
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2022048556
MO
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022048556
PROVISIONAL LICENSE PROFESSIONAL COUNSELOR
MO
Enumeration date
11/16/2022
Last updated
12/30/2022
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