| Anodyne Therapy, Llc | |
|
1007 N College Ave Ste #1 Columbia MO 65201-4794 | |
| (573) 529-0732 | |
| Not Available |
| Full Name | Anodyne Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1007 N College Ave, Columbia, Missouri |
| Authorized Official Name and Position | Kittie Ann Rogers (LCSW) |
| Authorized Official Contact | 5735290732 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anodyne Therapy, Llc 504 N William St Columbia MO 65201-5654 Ph: (573) 529-0732 | Anodyne Therapy, Llc 1007 N College Ave Ste #1 Columbia MO 65201-4794 Ph: (573) 529-0732 |
| NPI Number | 1942577028 |
|---|---|
| Provider Enumeration Date | 11/17/2011 |
| Last Update Date | 11/17/2011 |
| Medicare PECOS PAC ID | 9830348390 |
|---|---|
| Medicare Enrollment ID | O20120927000609 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942577028 | NPI | - | NPPES |
| 497810218 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 002690 (Missouri) | Primary |
| Provider Name | Kathleen A Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144229428 PECOS PAC ID: 6800081001 Enrollment ID: I20101113000134 |
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