Individual
IVONNE PALOMA OCAMPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
73038
TX
103TC0700X
Clinical Psychologist
Primary
2019037971
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14234178
CAQH
—
05
—
490075964
—
MO
Enumeration date
03/06/2018
Last updated
06/05/2023
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