Individual
FANCILLA ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
925 STATE HIGHWAY V V, KENNETT, MO 63857
(573) 888-5925
Mailing address
20 S SPRIGG ST, CAPE GIRARDEAU, MO 63703-6212
(636) 485-1635
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/10/2019
Last updated
01/10/2019
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