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General NPI Number Information
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NPI Number | 1568285906
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Entity Type | Individual
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Provider Name | OLIVIA ARDEN GUENGERICH LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 3506 S CULPEPPER CIR STE D
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City | SPRINGFIELD
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State | MO
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Zip | 65804-4251
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Country | US
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Telephone | 417-893-9359
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Fax | 417-450-4896
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Provider Business Mailing Address
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Address Line | 5844 S GERANIUM LN
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City | BATTLEFIELD
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State | MO
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Zip | 65619-8700
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Country | US
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Telephone | 573-692-0170
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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 | 2024030294
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License Number State | MO
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