Healthcare Provider Details

I. General information

NPI: 1730088758
Provider Name (Legal Business Name): OLIVIA GRACE BARROTT S-MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2026
Last Update Date: 11/04/2026
Certification Date: 11/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 S PICKWICK AVE
SPRINGFIELD MO
65802-3339
US

IV. Provider business mailing address

3255 E PORTLAND ST APT 204
SPRINGFIELD MO
65804-6928
US

V. Phone/Fax

Practice location:
  • Phone: 417-413-4774
  • Fax:
Mailing address:
  • Phone: 417-598-8296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: