Healthcare Provider Details

I. General information

NPI: 1497008171
Provider Name (Legal Business Name): MICHELLE CHARLENE TROYER LCSW, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2012
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 W MELVILLE RD
SPRINGFIELD MO
65803-1675
US

IV. Provider business mailing address

1108 W BUTTERFIELD DR
NIXA MO
65714-7042
US

V. Phone/Fax

Practice location:
  • Phone: 417-890-5533
  • Fax:
Mailing address:
  • Phone: 417-343-9118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2004031861
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: