Individual
MARY ELEANOR GIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1450 E 10TH ST, ROLLA, MO 65401-3648
(573) 364-7551
Mailing address
650B SALEM AVE, ROLLA, MO 65401-3409
(785) 550-3715
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2017024119
MO
Other
Enumeration date
08/22/2017
Last updated
11/28/2017
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