Individual
MR. BRIAN JESSE PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2302 MILITIA DR, JEFFERSON CITY, MO 65101-1203
(573) 638-9500
(573) 638-9812
Mailing address
2302 MILITIA DR, JEFFERSON CITY, MO 65101-1203
(573) 638-2712
(573) 638-9815
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2008002315
MO
Other
Enumeration date
09/06/2013
Last updated
09/06/2013
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