Individual
DR. CYNTHIA L HACKATHORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1706 E ELM ST, JEFFERSON CITY, MO 65102
(573) 526-2999
Mailing address
4803 CLARK LANE, APT 101, COLUMBIA, MO 65202-0034
(405) 795-7311
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
2011001093
MO
Other
Enumeration date
07/02/2008
Last updated
09/02/2016
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