Individual
REBEKAH ANTOINETTE PURVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 E 5TH ST, FULTON, MO 65251
(573) 592-3014
Mailing address
600 E 5TH ST, FULTON, MO 65251-1753
(573) 592-3014
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2019036908
MO
Other
Enumeration date
08/09/2017
Last updated
11/12/2019
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