Individual
MR. BRIAN DALE SOUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2131 S EASTGATE AVE, SPRINGFIELD, MO 65809-2146
(417) 763-3309
(417) 763-3331
Mailing address
2131 S EASTGATE AVE, SPRINGFIELD, MO 65809-2146
(417) 763-3309
(417) 763-3331
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MO 2011008666
MO
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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