Individual
MRS. BRENDA MCGAVOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH,D
Contact information
Practice address
2716 FORUM BLVD, SUITE 2B, COLUMBIA, MO 65203-5450
(573) 446-4039
(573) 446-4123
Mailing address
2716 FORUM BLVD, SUITE 2B, COLUMBIA, MO 65203-5450
(573) 446-4039
(573) 446-4123
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01036
MO
Other
Enumeration date
01/18/2006
Last updated
09/07/2011
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