Individual
MRS. KIM ANNE DOERGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
757 TAHLEQUAH LN, CAPE GIRARDEAU, MO 63701-8145
(636) 328-5641
Mailing address
757 TAHLEQUAH LN, CAPE GIRARDEAU, MO 63701-8145
(636) 328-5641
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004678
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004678
LCSW
MO
Enumeration date
04/24/2008
Last updated
05/27/2022
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