Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2002021883 | MO |
NPI | 1134107097 |
---|---|
Provider Name | Deborah R Frost |
First Address | Rolla, MO 65401-7592 |
Second Address | Rolla, MO 65401-3648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2006 |
Last Update Date | 10/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
495937807 | (05) | MO |