Individual
SHIRLEY REBEKAH WHITLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLCP
Contact information
Practice address
RR 2 BOX 1664, WHEATLAND, MO 65779-9706
(816) 289-0472
Mailing address
RR 2 BOX 1664, WHEATLAND, MO 65779-9706
(816) 289-0472
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2012032149
MO
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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