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General NPI Number Information
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NPI Number | 1699750562
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Entity Type | Individual
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Provider Name | JAMIE HEATHER MEADOWS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 29 S 9TH ST STE 208
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City | COLUMBIA
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State | MO
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Zip | 65201-4884
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Country | US
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Telephone | 914-343-0604
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Fax | 888-690-5301
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Provider Business Mailing Address
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Address Line | 29 S 9TH ST STE 208
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City | COLUMBIA
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State | MO
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Zip | 65201-4884
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Country | US
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Telephone | 914-343-0604
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Fax | 888-690-5301
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2004024851
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License Number State | MO
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