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General NPI Number Information
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NPI Number | 1063462091
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Entity Type | Individual
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Provider Name | BARBARA JEAN DOUGLASS LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 3016 DUPONT CIR
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-6188
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Country | US
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Telephone | 888-403-1071
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 803919
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City | KANSAS CITY
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State | MO
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Zip | 64180-3919
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Country | US
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Telephone | 660-885-8131
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2005019882
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License Number State | MO
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