Individual
JOHN RICHARD SPOONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2085 S BOSTON PL, BOLIVAR, MO 65613-2871
(417) 326-2418
(417) 326-2419
Mailing address
2085 S BOSTON PL, BOLIVAR, MO 65613-2871
(417) 326-2418
(417) 326-2419
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2002023735
MO
103TC0700X
Clinical Psychologist
Primary
2006034106
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193564
BLUE CROSS BLUE SHIELD
MO
05
—
495966319
—
MO
Enumeration date
01/25/2006
Last updated
09/18/2013
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