Individual
KELLY MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4 HICKORY RIDGE RD STE 600, HILLSBORO, MO 63050-5117
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2021046454
MO
Other
Enumeration date
11/17/2022
Last updated
10/18/2023
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