Individual provider · Type 1 NPI
Thada Pulliam, LPC
Professional Counselor · Blue Springs, MO
NPI number
1396875787
Active
Practice location
1209 NW R Idge Dr., C
Blue Springs, MO 64015
Mailing address
619 NE Bordner Dr
Lees Summit, MO 64086-6228
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 1999136662 (MO) |
Professional Counselor: Definition to come...
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About NPI 1396875787
Thada Pulliam, LPC's National Provider Identifier is 1396875787, issued on Mar 6, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Blue Springs, MO. The record was last updated on Jul 9, 2007.