Individual
KATRINA LOUISE ROUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LMSW
Contact information
Practice address
1310 E KINGSLEY ST STE B, SPRINGFIELD, MO 65804-7238
(417) 319-1379
Mailing address
2158 S LONE PINE AVE, SPRINGFIELD, MO 65804
(417) 689-1206
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2020028693
MO
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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