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Individual

MRS. SARA NICOLE IVERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA LMHC LPC

Contact information

Practice address
3259 E SUNSHINE ST STE L, SPRINGFIELD, MO 65804-2143
(319) 594-4564
Mailing address
620 E CHEROKEE ST, SPRINGFIELD, MO 65807-2610
(319) 594-4564

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
001288
IA
101YM0800X
Mental Health Counselor
Primary
2024014163
MO

Other

Enumeration date
12/10/2010
Last updated
08/20/2024
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