Jackie L Dean is a Clinical in Springfield, Missouri. Jackie L Dean practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jackie L Dean is 1174728109. The last update date is 2019-03-22.
Jackie L Dean's current location address is 930 S Robberson Ave, Springfield, Missouri. You can contact this provider via phone number 4177615540. The mailing address for Jackie L Dean is 930 S Robberson Ave, Springfield, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jackie L Dean |
|---|---|
| Address | 930 S Robberson Ave, Springfield, Missouri |
| Phone Number | 4177615540 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PSYD, LP |
NPI Number Detail
| NPI Number | 1174728109 |
|---|---|
| Provider Enumeration Date | 2007-06-19 |
| Last Updated Date | 2019-03-22 |
Provider Mailing Address Detail
| Address | 930 S Robberson Ave |
|---|---|
| City | Springfield |
| State | Missouri (MO) |
| Post Code | 658063220 |
| Phone Number | 4177615540 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 2007015262 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 498802818 | MO | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Jackie L Dean by the Centers for Medicare & Medicaid Services?
The Jackie L Dean has been issued the NPI (National Provider Identifier) 1174728109, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Jackie L Dean is located?
The Jackie L Dean is situated at the following address: 930 S Robberson Ave, Springfield, MO, 658063220.
What is Jackie L Dean's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jackie L Dean's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 103Tc0700X.
On what date did Jackie L Dean receive its 1174728109 assignment from the Centers for Medicare & Medicaid Services?
The Jackie L Dean was assigned its 1174728109 on 2007-06-19, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Jackie L Dean's information last updated?
The Jackie L Dean's information was last updated on 2019-03-22.
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