Organization
ALTER EGO COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY S MARTIN LCSW (OWNER/THERAPIST)
(660) 232-1107
Entity
Organization
Contact information
Practice address
505 S KENTUCKY AVE, SUITE D, SEDALIA, MO 65301-4254
(660) 232-1107
Mailing address
505 S KENTUCKY AVE, SUITE D, SEDALIA, MO 65301-4254
(660) 232-1107
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2011024378
MO
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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