Organization
CLEAR CREEK COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY LYNN THOENEN PLPC (COUNSELOR)
(573) 619-8919
Entity
Organization
Contact information
Practice address
3646 N FARM ROAD 89, WILLARD, MO 65781-8330
(573) 619-8919
Mailing address
3646 NORTH FARM ROAD 89, WILLARD, MO 65781
(417) 850-4555
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
2016035718
MO
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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