Individual
MR. STAN DWANE BUFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, NCC, PLCP, EMDR
Contact information
Practice address
3734 SOUTH AVE STE C, SPRINGFIELD, MO 65807-5291
(417) 882-6767
(417) 882-6787
Mailing address
4236 S BROADWAY AVE, SPRINGFIELD, MO 65810-1617
(417) 496-6062
(417) 882-6787
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2016028726
MO
101YM0800X
Mental Health Counselor
2016028726
MO
101YP2500X
Professional Counselor
2016028726
MO
106H00000X
Marriage & Family Therapist
2016028726
MO
Other
Enumeration date
02/09/2018
Last updated
02/09/2018
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