Individual
LYSSA BIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4235 S CHARLESTON AVE, SPRINGFIELD, MO 65804-4370
(417) 319-1502
Mailing address
4235 S CHARLESTON AVE, SPRINGFIELD, MO 65804-4370
(417) 319-1502
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MO
Other
Enumeration date
04/29/2025
Last updated
04/29/2025
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