Individual
CHRISTOPHER R SHUPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
103 W 10TH ST, ROLLA, MO 65401-3247
(315) 955-2823
Mailing address
103 W 10TH ST, ROLLA, MO 65401-3247
(315) 955-2823
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2022029271
MO
1041C0700X
Clinical Social Worker
Primary
2024034052
MO
Other
Enumeration date
08/04/2022
Last updated
08/28/2024
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