Organization
DR. MICHAEL S. LONDE, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S LONDE LADC (OWNER)
(417) 781-2868
Entity
Organization
Contact information
Practice address
1704 E 4TH ST, JOPLIN, MO 64801-1807
(417) 781-2868
(417) 781-1922
Mailing address
1704 E 4TH ST, JOPLIN, MO 64801-1807
(417) 781-2868
(417) 781-1922
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1175
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11629935
CAQH
MO
Enumeration date
02/10/2015
Last updated
02/10/2015
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