Individual
MS. KELLI MARIE WINDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3101C S KIMBROUGH AVE, SPRINGFIELD, MO 65807-5011
(417) 866-7773
(417) 866-7792
Mailing address
3101C S KIMBROUGH AVE, SPRINGFIELD, MO 65807-5011
(417) 866-7773
(417) 866-7792
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2019012201
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912141789
—
MO
05
—
830068470
—
MO
Enumeration date
04/19/2019
Last updated
07/24/2019
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