Individual
GRACE R DEVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LPC
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2010006115
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494153208
—
MO
Enumeration date
05/14/2010
Last updated
06/26/2024
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