Individual
BARBARA LEA RADOVANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3850 S NATIONAL AVE, STE 770, SPRINGFIELD, MO 65807-5287
(417) 269-6891
(417) 269-5595
Mailing address
1423 N JEFFERSON AVE, SPRINGFIELD, MO 65802-1917
(417) 269-3465
(417) 269-8189
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
R0427
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132242
BLUE SHIELD
MO
Enumeration date
02/26/2007
Last updated
07/08/2007
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