Individual
MRS. HOLLY LEE DIVIN-DECKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
6007 N 21ST ST, OZARK, MO 65721-7634
(417) 581-6911
Mailing address
4623 S 149TH RD, BOLIVAR, MO 65613-8545
(417) 326-2611
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2006029148
MO
Other
Enumeration date
02/14/2007
Last updated
07/09/2007
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