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State of Missouri — NPI 1447886288, Jefferson City, MO | NPI Central

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NPI 1447886288

OrganizationActive

State of Missouri

NPI 1447886288 · Rehabilitation Psychologist · Jefferson City, MO

Provider details

NPI number: 1447886288
Entity type: Organization
Primary specialty: Rehabilitation PsychologistBehavioral Health & Social Service Providers
Parent organization: State of Missouri
Organization subpart: Yes
Authorized official: Molly Boeckmann, Director of Administrative Services(573) 751-4055

Specialties & taxonomies

Rehabilitation PsychologistPrimary103TR0400X
Behavioral Health & Social Service Providers

Practice location

1706 E Elm St

Jefferson City, MO 65101

Phone: (573) 751-3398

Approximate (ZIP-level) locationGet directions

More MO providers

Mailing address

Po Box 687

Jefferson City, MO 65102-0687

Other names (DBA / former)

Doing business as: Cpr Adult
Doing business as: Cpr Adult

Registry dates

Enumerated: 2020-03-12
Last updated: 2020-09-03
Certified: 2020-09-03

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.