Individual
MIMI CRISENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
17 E KANSAS ST STE 200, LIBERTY, MO 64068-2372
(816) 287-0001
Mailing address
13521 SHORT CIR, SMITHVILLE, MO 64089-7819
(720) 251-5246
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2024008501
MO
Other
Enumeration date
07/26/2024
Last updated
07/26/2024
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