Individual
MISS JENIFER DAWN STURDIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
3800 S NATIONAL AVE STE 770, SPRINGFIELD, MO 65807-5283
(417) 269-6891
(417) 269-5595
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2003031833
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12602676
CAQH
—
Enumeration date
11/15/2010
Last updated
10/28/2020
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