Individual
INDIANA DESIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2025 E CHESTNUT EXPY, SPRINGFIELD, MO 65802-2222
(765) 413-9194
Mailing address
4404 S HEMOCK AVE, SPRINGFIELD, MO 65810
(765) 413-9194
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2023033707
MO
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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