Individual
DR. JAY BRADLEY MUSGRAVE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD, LPC
Contact information
Practice address
1221 KINGSWAY DR, SUITE 5, CAPE GIRARDEAU, MO 63701-3603
(573) 651-4206
(573) 339-0053
Mailing address
1221 KINGSWAY DR, SUITE 5, CAPE GIRARDEAU, MO 63701-3603
(573) 651-4206
(573) 339-0053
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000568
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5634
BLUE CROSS
MO
Enumeration date
05/19/2006
Last updated
07/08/2007
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