person
Mrs. Mary Ellen Theodore, LPC
Professional Counselor in Maryville, Missouri
NPI 1699933630

Mary Ellen Theodore is a Professional Counselor based in Maryville, MO and is specialized in Professional. Mary Ellen Theodore practices in Maryville, MO and has the professional credentials of LPC. The NPI Number for Mary Ellen Theodore is 1699933630 and holds a License No. 002394 (Missouri).

The current practice location address for Mary Ellen Theodore is 321 N Munn Ave, Maryville, MO and can be reached out via phone at 660-582-3086 and via fax at 660-582-3086.

Location: 321 N Munn Ave, Maryville, MO, 64468-2146
person
Provider Profile Details
NPI Number
1699933630
Provider Name
Mary Ellen Theodore
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
321 N Munn Ave, Maryville, MO, 64468-2146
Phone Number
660-582-3086
Fax Number
660-582-3086
Provider Enumeration Date
05/27/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
321 N Munn Ave
City
State
Zip
64468-2146
Phone Number
660-582-3086
Fax Number
660-582-3086
person
Provider Business Mailing Address Details
Address
321 N Munn Ave
City
State
Zip
64468-2146
Phone Number
660-582-3086
Fax Number
660-582-3086
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
002394 (Missouri)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
002394 (Missouri)
Definition
Definition to come...
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