Theodore, Mary Ellen

Theodore, Mary Ellen is an sole proprietor health care provider with primary practice located at 321 N Munn Ave , Maryville MO 64468-2146. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Theodore, Mary Ellen can be contacted via phone (660) 582-3086.

Contact Information

Primary practice address
321 N Munn Ave Maryville MO 64468-2146
Phone: (660) 582-3086
Fax: (660) 582-3086
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 002394 Missouri
Behavioral Health & Social Service Providers / Professional 101YP2500X 002394 Missouri

Profile Details

NPI number 1699933630
LBN Legal business name Theodore, Mary Ellen
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 27th, 2008
Last updated May 27th, 2008 - about 18 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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