Individual
LOIS JUNE MADDUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1404 E FAIRWIND, OZARK, MO 65721-6379
(417) 569-3726
Mailing address
1404 E FAIRWIND, OZARK, MO 65721-6379
(417) 569-3726
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2000175696
MO
1041C0700X
Clinical Social Worker
Primary
2000175696
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104100000X
—
MO
Enumeration date
11/04/2009
Last updated
11/04/2009
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