Individual
MRS. LIZABETH MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
243 SE 15TH RD, LAMAR, MO 64759-9272
(417) 214-3801
Mailing address
243 SE 15TH RD, LAMAR, MO 64759-9272
(417) 214-3801
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
MH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190741720004
DRIVERS LICENSE
MO
Enumeration date
11/25/2020
Last updated
11/25/2020
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