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General NPI Number Information
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NPI Number | 1972811826
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Entity Type | Individual
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Provider Name | RENEE LYNN MAPES PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 3407 BERRYWOOD DR. SUITE 200
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City | COLUMBIA
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State | MO
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Zip | 65201
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Country | US
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Telephone | 573-443-1177
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Fax | 573-499-1564
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Provider Business Mailing Address
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Address Line | PO BOX 319
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City | ASHLAND
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State | MO
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Zip | 65010-0319
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Country | US
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Telephone | 573-424-5305
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2010030787
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License Number State | MO
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