Organization
SAC RIVER INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA MARIE ROLLER PSY.D. (CLINICAL PSYCHOLOGIST)
(417) 777-1476
Entity
Organization
Contact information
Practice address
131 ELM STREET, DADEVILLE, MO 65635
(417) 995-2476
(866) 520-5586
Mailing address
928 E DADE 68, DADEVILLE, MO 65635-8112
(417) 777-1476
(866) 520-5586
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2006033497
MO
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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