SPENCER L ELLIS

JOPLIN, MO
NPI1851429294
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MO  1342)
Enumeration Date2007-02-28
Last Update Date2007-07-08
Business Address
-- SPENCER L ELLIS CASAC
2808 S. PICHER ST.
JOPLIN, MO 64803
Phone number: 417-347-7700
Mailing Address
-- SPENCER L ELLIS CASAC
105 W CRESTWOOD DR
MONETT, MO 65708-9577
Phone number: 417-235-3001