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General NPI Number Information
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NPI Number | 1902494685
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Entity Type | Organization
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Legal Business Name | ASPIRE CHANGE LLC
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 20411 HIGHWAY M
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City | BELLE
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State | MO
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Zip | 65013-2144
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Country | US
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Telephone | 573-202-3211
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Fax |
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Provider Business Mailing Address
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Address Line | 20411 HIGHWAY M
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City | BELLE
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State | MO
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Zip | 65013-2144
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Country | US
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Telephone | 573-202-3211
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MICHELLE G BOATMAN
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Credential | LPC
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Telephone | 573-202-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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