Individual
DEDE CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAADCII
Contact information
Practice address
1401 S ELLIOTT AVE, AURORA, MO 65605-2103
(417) 671-9856
Mailing address
1305 BROOKSIDE LN, AURORA, MO 65605-8158
(417) 569-2143
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9512
MO
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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