Organization
SAC RIVER COUNSELING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA MARIE ROLLER PSY.D. (PRESIDENT)
(417) 777-1476
Entity
Organization
Contact information
Practice address
406 COLLEGE ST, #2, GREENFIELD, MO 65661-1346
(417) 637-1476
Mailing address
928 E DADE 68, DADEVILLE, MO 65635-8112
(417) 777-1476
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2004037100
MO
103TC0700X
Clinical Psychologist
Primary
2006033497
MO
106H00000X
Marriage & Family Therapist
2007003463
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497227124
—
MO
Enumeration date
06/25/2007
Last updated
10/12/2016
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