Healthcare Provider Details

I. General information

NPI: 1962710996
Provider Name (Legal Business Name): JAMES MICHAEL BARON MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2010
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5571 NORTH GRETNA ROAD
BRANSON MO
65616
US

IV. Provider business mailing address

5571 NORTH GRETNA ROAD
BRANSON MO
65616
US

V. Phone/Fax

Practice location:
  • Phone: 417-243-2300
  • Fax: 417-243-2381
Mailing address:
  • Phone: 417-243-2300
  • Fax: 417-243-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC52249
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number60341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: