Organization
INSIGHT DYNAMICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANEISA LYNN SHERRILL-MATTOX LCSW (LICENSED CLINICAL SOCIAL WORKER)
(660) 882-6400
Entity
Organization
Contact information
Practice address
413 E SPRING ST, BOONVILLE, MO 65233-1573
(166) 088-2640
Mailing address
413 E SPRING ST, BOONVILLE, MO 65233-1573
(166) 088-2640
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490078150
—
MO
Enumeration date
12/13/2022
Last updated
12/13/2022
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