Provider Demographics
NPI:1467559187
Name:CAMERON, HOWARD DANIEL (MA, MFT)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:DANIEL
Last Name:CAMERON
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 E SWALLOW ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-6728
Mailing Address - Country:US
Mailing Address - Phone:417-225-2916
Mailing Address - Fax:
Practice Address - Street 1:3023 S FORT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-4272
Practice Address - Country:US
Practice Address - Phone:417-225-2917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006023863106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist