Provider Demographics
NPI:1235474537
Name:MING, AUDREY ELAINE (LPC)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:ELAINE
Last Name:MING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:ELAINE
Other - Last Name:GIERINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-0333
Mailing Address - Country:US
Mailing Address - Phone:660-886-2253
Mailing Address - Fax:660-886-6601
Practice Address - Street 1:1126 E HIGHWAY WW
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-4641
Practice Address - Country:US
Practice Address - Phone:660-886-2253
Practice Address - Fax:660-886-6601
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010027824101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional