Individual
JACQUELYN SHAE HITCHCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1212 W LOMBARD ST, SPRINGFIELD, MO 65806-2720
(417) 865-1646
Mailing address
699 LONE HICKORY RD, OZARK, MO 65721-7762
(417) 813-9117
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2020027688
MO
Other
Enumeration date
09/10/2020
Last updated
09/10/2020
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