Organization
MINDFULLY WHOLE PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARBARA MANZER FARRELL PSYD (OWNER)
(417) 413-4991
Entity
Organization
Contact information
Practice address
4057 W ILDEREEN ST, SPRINGFIELD, MO 65807-1063
(417) 413-4991
(417) 719-7995
Mailing address
4057 W ILDEREEN ST, SPRINGFIELD, MO 65807-1063
(417) 413-4991
(417) 719-7995
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
2016005653
MO
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
2016005653
MO
Other
Enumeration date
01/19/2017
Last updated
02/13/2017
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