Provider Demographics
NPI:1790063196
Name:HOWELL, MARY (MS)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 STATE ROUTE U
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65793-3426
Mailing Address - Country:US
Mailing Address - Phone:417-372-3303
Mailing Address - Fax:
Practice Address - Street 1:2695 STATE ROUTE U
Practice Address - Street 2:
Practice Address - City:WILLOW SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65793-3426
Practice Address - Country:US
Practice Address - Phone:417-372-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011024772101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional