Individual
DR. CRAIG PATRICK COENEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
2053 S WAVERLY AVE STE D, SPRINGFIELD, MO 65804-2497
(417) 315-4962
(888) 884-4101
Mailing address
2053 S WAVERLY AVE SUITE D, #101, SPRINGFIELD, MO 65807-1497
(417) 315-4962
(888) 884-4101
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2010024663
MO
103TC0700X
Clinical Psychologist
Primary
2016035928
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499955409
—
MO
Enumeration date
02/05/2007
Last updated
10/16/2017
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