Individual
DON ELDRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 ICHORD AVE STE C, WAYNESVILLE, MO 65583-3449
(573) 586-7857
Mailing address
PO BOX 1008, SAINT ROBERT, MO 65584-1008
(573) 586-7857
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2012026714
MO
101YA0400X
Addiction (Substance Use Disorder) Counselor
2012026714
MO
101YM0800X
Mental Health Counselor
2012026714
MO
Other
Enumeration date
08/09/2012
Last updated
08/10/2012
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