Organization
JCMG MENTAL HEALTH, L.L.C.
Active
Other names
Jane Domke, PhD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL CRAIGHEAD M.D. (COO)
(573) 556-7776
Entity
Organization
Contact information
Practice address
701 W HIGH ST, ROOM 14, JEFFERSON CITY, MO 65101-1525
(573) 636-3313
Mailing address
701 W HIGH ST, JEFFERSON CITY, MO 65101-1525
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
12/22/2006
Last updated
11/29/2007
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