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NPI Code Detail

MEDICARE: ALYSON WYSONG-HARDER M.S.W.

MEDICARE: ALYSON WYSONG-HARDER M.S.W.
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
11041C0700XClinical Social Worker2003032191MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396820338
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSON WYSONG-HARDER M.S.W.
Provider Business Mailing Address
First Line : 300 W CHERRY ST
Second Line :
City : NEVADA
State : MO
Zip : 64772-2202
Country : US
Telephone Number : 417-667-4230
Fax Number : 417-667-7607
Provider Business Practice Location Address
First Line : 300 W CHERRY ST
Second Line :
City : NEVADA
State : MO
Zip : 64772-2202
Country : US
Telephone Number : 417-667-4230
Fax Number : 417-667-7607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/09/2007

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