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Individual

KATHLEEN MARION LASAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 778-4603
Mailing address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
67372
MO

Other

Enumeration date
07/14/2006
Last updated
07/08/2007
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