Individual
JESSI WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
614 SOUTH AVE, SPRINGFIELD, MO 65806-3110
(417) 869-9011
Mailing address
2890 SAND SPRINGS RD, MARSHFIELD, MO 65706-8190
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2012011627
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2012011627
COMMITTE FOR PROFESSIONAL COUNSELORS, DIVISION OF REGISTRATION
MO
Enumeration date
06/26/2014
Last updated
06/26/2014
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