Healthcare Provider Details

I. General information

NPI: 1639814163
Provider Name (Legal Business Name): JULIAN E LAWSON PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 W HUBBLE DR
MARSHFIELD MO
65706-1532
US

IV. Provider business mailing address

PO BOX 256
MARSHFIELD MO
65706-0256
US

V. Phone/Fax

Practice location:
  • Phone: 417-859-7746
  • Fax: 417-859-7411
Mailing address:
  • Phone: 417-859-7746
  • Fax: 417-859-7411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2022014709
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: