Individual
LINDA D. MAGRUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
101 S MAIN ST, POPLAR BLUFF, MO 63901-5843
(573) 686-5090
(573) 785-4104
Mailing address
101 SOUTH MAIN, POPLAR BLUFF, MO 63901-5202
(573) 686-5090
(573) 785-4104
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2000168791
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175128
BLUE CROSS BLUE SHIELD
MO
01
—
2104426
CIGNA
MO
01
—
430956146
TRICARE
MO
05
—
495097016
—
MO
01
—
685831
HEALTHLINK
MO
Enumeration date
12/28/2005
Last updated
09/18/2017
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