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Contact Information

PHELPS COUNTY REGIONAL MEDICAL CENTER
1206 HOMELIFE DR.
ROLLA, MO65401
 Phone: 357-364-2007
 Fax: 573-364-8695
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for PHELPS COUNTY REGIONAL MEDICAL CENTER · (Female)

NPI Number 1376648725
Status Active
Credentials
Entity Individual
Enumeration date 09/13/2006
Last updated 07/15/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO License # 20020110
  • MO Medicaid 499035616
  • MO Other 20020110 MO STATE
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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