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Contact Information

LIFESONG FOR GROWTH AND WELLNESS LLC
3401 W TRUMAN BLVD
STE 100
JEFFERSON CITY, MO65109-5752
 Phone: 573-644-7909
 Fax: 573-644-7908
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for LIFESONG FOR GROWTH AND WELLNESS LLC · (Female)

NPI Number 1114228335
Status Active
Credentials
Entity Individual
Enumeration date 11/04/2010
Last updated 05/02/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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