Most Relevant Information
Provider Data
| NPI Number: | 1003325317 |
| Provider Name: | LAURA JEAN SOUTH LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 2009007303 |
Most Important Dates
| Enumeration Date: | 09/29/2017 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
7366 COUNTY ROAD 180
CARTHAGE
MO
648367679
Practice Location Phone/Fax
| Phone: | 4177931811 |
| Fax: |
Provider Mailing Location
7366 COUNTY ROAD 180
CARTHAGE
MO
648367679
Provider Mailing Phone/Fax
| Phone: | 4177931811 |
| Fax: |