Individual
STACY BARHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
827 W COMMERCIAL ST, MANSFIELD, MO 65704-9520
(417) 924-8188
Mailing address
827 W COMMERCIAL ST, MANSFIELD, MO 65704-9520
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2011036261
MO
103TC0700X
Clinical Psychologist
Primary
2014008375
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821374935
—
MO
Enumeration date
11/02/2011
Last updated
03/19/2014
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