| Same | |
|
101 S Main St Poplar Bluff MO 63901-5843 | |
| (573) 686-5090 | |
| (573) 518-0329 |
| Full Name | Same |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 101 S Main St, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Janet Sue Mclane-li (LCSW) |
| Authorized Official Contact | 5736865090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Same Po Box 506 Park Hills MO 63601-0506 Ph: (573) 431-0554 | Same 101 S Main St Poplar Bluff MO 63901-5843 Ph: (573) 686-5090 |
| NPI Number | 1689690984 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689690984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2004035019 (Missouri) | Primary |
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