Individual
CERENDIA WOOLLUMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
101 S MAIN ST, POPLAR BLUFF, MO 63901-5843
(573) 624-6937
(573) 624-2350
Mailing address
PO BOX 107, POPLAR BLUFF, MO 63902-0107
(573) 624-6937
(573) 624-2350
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11824391
CAQH
—
05
—
1831367572
—
MO
01
—
2773
EAP IMPACT
—
Enumeration date
02/15/2008
Last updated
08/04/2011
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