Organization
WELLNESS COMPANY II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT F INGEGNERI PSY.D. (LICENSED PSYCHOLOGIST)
(417) 667-4230
Entity
Organization
Contact information
Practice address
300 W CHERRY ST, NEVADA, MO 64772-2202
(417) 667-4230
Mailing address
300 W CHERRY ST, NEVADA, MO 64772-2202
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01727
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000959100
CTS PROVIDER NUMBER
MO
01
—
23833053
BLUE CROSS/ BLUE SHIELD
MO
05
—
498039718
—
MO
Enumeration date
09/30/2012
Last updated
09/30/2012
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