Individual
MAXWELL BIRDNOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
1519 TYPHOON CT, COLUMBIA, MO 65202-3399
(314) 494-0484
Mailing address
1519 TYPHOON CT, COLUMBIA, MO 65202-3399
(314) 494-0484
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2023020895
MO
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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