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1295213619
TITUS SHANE MAYBERRY
JEFFERSON CITY, MO
NPI
1295213619
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MO 2018027808)
Enumeration Date
2018-07-30
Last Update Date
2019-12-05
Business Address
TITUS SHANE MAYBERRY LPC, MA
1905 STADIUM BLVD
JEFFERSON CITY, MO 65109
Phone number: 888-403-1071
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Mailing Address
TITUS SHANE MAYBERRY LPC, MA
1800 COMMUNITY
CLINTON, MO 64735-8804
Phone number: 660-885-8131
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