Individual
MARY CHRISTINE MAHANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
901 MO 174, REPUBLIC, MO 65738-1822
(417) 732-1822
Mailing address
4319 S NATIONAL AVE PMB 319, SPRINGFIELD, MO 65810
(417) 838-3490
(417) 763-3333
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2017007055
MO
Other
Enumeration date
10/30/2014
Last updated
12/20/2018
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