Individual
DR. JUDY K. STATLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
115 BROADWAY ST, CAPE GIRARDEAU, MO 63701-7326
(573) 334-0018
(573) 334-0984
Mailing address
724 JACKSON TRL, JACKSON, MO 63755-2616
(573) 243-3482
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001181
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11349681
CAQH
MO
01
—
188959
ANTHEM BLUECROSSBLUESHIEL
MO
01
—
656053
HEALTHLINK
MO
01
—
A309278
VALUE OPTIONS
MO
Enumeration date
07/14/2006
Last updated
08/13/2007
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