Healthcare Provider Details

I. General information

NPI: 1245259472
Provider Name (Legal Business Name): JAMES DEVON HUITT PH.D., LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1578 ARGO RD
CUBA MO
65453-6255
US

IV. Provider business mailing address

1578 ARGO RD
CUBA MO
65453-6255
US

V. Phone/Fax

Practice location:
  • Phone: 573-732-4575
  • Fax: 573-732-4577
Mailing address:
  • Phone: 573-732-4575
  • Fax: 573-732-4577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number300017
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: