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Individual

PATRICIA THAKUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRADC, CCDP, CS

Contact information

Practice address
404 E BATTLEFIELD ST # R, SPRINGFIELD, MO 65807-4802
(417) 865-8045
Mailing address
1316 E LAKEWOOD ST, SPRINGFIELD, MO 65804-7458
(417) 396-9025

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7849
MO

Other

Enumeration date
07/05/2018
Last updated
07/05/2018
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