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NPI Code Detail

MEDICARE: AMANDA CRABTREE PLPC

MEDICARE: AMANDA CRABTREE PLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor2011036951MO

General Provider Information

NPI Number : 1265799415
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA CRABTREE PLPC
Provider Business Mailing Address
First Line : 16801 N EDGEVIEW RD
Second Line :
City : CENTRALIA
State : MO
Zip : 65240-3741
Country : US
Telephone Number : 573-696-0661
Fax Number :
Provider Business Practice Location Address
First Line : 413 E SPRING ST
Second Line :
City : BOONVILLE
State : MO
Zip : 65233-1573
Country : US
Telephone Number : 660-882-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2012
Last Update Date : 04/12/2012

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Directions to “ AMANDA CRABTREE PLPC” Practice Location

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