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General NPI Number Information
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NPI Number | 1205119013
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Entity Type | Individual
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Provider Name | JENNIFER ELIZABETH CORBIN-DAULTON LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 300 W CHERRY ST
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City | NEVADA
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State | MO
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Zip | 64772-2202
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Country | US
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Telephone | 417-667-4230
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Fax | 417-667-7607
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Provider Business Mailing Address
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Address Line | 1500 W. ASHLAND
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City | NEVADA
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State | MO
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Zip | 64772
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Country | US
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Telephone | 417-667-2666
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Fax | 417-448-5683
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2011022369
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License Number State | MO
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