Provider Demographics
NPI:1912341603
Name:SYLVIA B MCQUEARY, L.L.C.
Entity Type:Organization
Organization Name:SYLVIA B MCQUEARY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:BARE
Authorized Official - Last Name:MCQUEARY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:417-619-8874
Mailing Address - Street 1:PO BOX 963
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-0963
Mailing Address - Country:US
Mailing Address - Phone:417-619-8874
Mailing Address - Fax:
Practice Address - Street 1:201 S KILLINGSWORTH
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613
Practice Address - Country:US
Practice Address - Phone:417-619-8874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty