Individual
JIM A DELAMOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D., L.P.C.
Contact information
Practice address
1111 S GLENSTONE AVE, SUITE 201, SPRINGFIELD, MO 65804-0313
(417) 862-8282
(417) 862-8805
Mailing address
1111 S GLENSTONE AVE, SUITE 201, SPRINGFIELD, MO 65804-0313
(417) 862-8282
(417) 862-8805
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2000167860
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150944
BCBS PROVIDER NUMBER
MO
Enumeration date
01/12/2007
Last updated
07/09/2007
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