Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 2019042104 | MO |
NPI | 1003452186 |
---|---|
Provider Name | Lindsey Marie Kraus |
First Address | Clinton, MO 64735-8804 |
Second Address | Union, MO 63084-3397 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2019 |
Last Update Date | 18/11/2021 |