Individual
MARILYN C SHOUMAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LCSW BCD
Contact information
Practice address
1580 W COLUMBIA ST, FARMINGTON, MO 63640-3512
(573) 760-1365
(573) 760-0354
Mailing address
1580 W COLUMBIA ST, FARMINGTON, MO 63640-3512
(573) 760-1365
(573) 760-0354
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2008009622
MO
1041C0700X
Clinical Social Worker
Primary
2008009622
MO
Other
Enumeration date
10/09/2009
Last updated
02/21/2014
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