Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC1900X | Counseling Psychologist | 01525 | MO |
NPI | 1083619506 |
---|---|
Provider Name | Ward M Lawson |
First Address | Marshfield, MO 65706-1532 |
Second Address | Marshfield, MO 65706-1532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2005 |
Last Update Date | 04/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
493580138 | (05) | MO |