Individual
NANCY M. SERVICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2005028851
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497458406
—
MO
01
—
83612
AR BLUE SHIELD #
MO
Enumeration date
02/15/2007
Last updated
07/23/2008
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