Organization
JCMG MENTAL HEALTH, L.L.C.
Active
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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