Individual
DR. MICHELLE RENEE PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
611 N FOUNTAIN ST, CAPE GIRARDEAU, MO 63701-7244
(573) 651-2705
(573) 986-4994
Mailing address
1 UNIVERSITY PLZ, CAPE GIRARDEAU, MO 63701-4710
(573) 651-2705
(573) 986-4994
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2012038439
MO
103T00000X
Psychologist
LP 1649
KS
Other
Enumeration date
02/15/2011
Last updated
01/08/2013
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