Haldeman, Mary Beth

Haldeman, Mary Beth is an individual health care provider with primary practice located at 3001 Warrior Ln , Poplar Bluff MO 63901-8685. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Haldeman, Mary Beth can be contacted via phone (573) 686-1200.

Contact Information

Primary practice address
3001 Warrior Ln Poplar Bluff MO 63901-8685
Phone: (573) 686-1200
Fax: (573) 686-1029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2007002228 Missouri

Profile Details

NPI number 1417088220
LBN Legal business name Haldeman, Mary Beth
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2007
Last updated Mar 12th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417088220 NPPES
Other 11792021 CAQH
Other 2651 CAQH
MEDICAID 494914906 CAQH

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