Individual
MRS. NAN SUSAN HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1550 E BATTLEFIELD ST, SUITE A, SPRINGFIELD, MO 65804-3704
(417) 869-9011
Mailing address
2473 E EDGEWOOD ST, SPRINGFIELD, MO 65804-3905
(417) 886-8273
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2006009175
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006009175
COUNSELOR LICENSE NUMBER
MO
05
—
491221107
—
MO
Enumeration date
03/23/2007
Last updated
07/08/2007
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