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1851429294
SPENCER L ELLIS
JOPLIN, MO
NPI
1851429294
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MO 1342)
Enumeration Date
2007-02-28
Last Update Date
2007-07-08
Business Address
-- SPENCER L ELLIS CASAC
2808 S. PICHER ST.
JOPLIN, MO 64803
Phone number: 417-347-7700
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Mailing Address
-- SPENCER L ELLIS CASAC
105 W CRESTWOOD DR
MONETT, MO 65708-9577
Phone number: 417-235-3001
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