Provider Demographics
NPI:1891124962
Name:IRONS, VANESSA LYNNE (MA PLPC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LYNNE
Last Name:IRONS
Suffix:
Gender:F
Credentials:MA PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 S CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-1445
Mailing Address - Country:US
Mailing Address - Phone:417-865-8943
Mailing Address - Fax:417-831-6839
Practice Address - Street 1:1322 S CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-1445
Practice Address - Country:US
Practice Address - Phone:417-865-8943
Practice Address - Fax:417-831-6839
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013038034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional