Individual
MR. BRADY EVAN CLEVENGER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS PLPC
Contact information
Practice address
2914 E 32ND ST, SUITE 308, JOPLIN, MO 64804-4402
(417) 624-8333
(417) 624-0349
Mailing address
PO BOX 8225, JOPLIN, MO 64802-8225
(417) 624-4960
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2005036369
MO
Other
Enumeration date
03/31/2006
Last updated
07/08/2007
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