Jonathan Distaulo, PLPC
Jonathan Distaulo, PLPC is a Professional Counselor in Springfield, Missouri. Licensed in Missouri. Registered with an NPI since 2017.
- Licensed in
- MO
- In the registry since
- 2017
Practice location Address checks out
3101C S Kimbrough AveSpringfield, MO 65807-5011
Phone: (417) 866-7773
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Specialties & licences
| Professional Counselor (primary) | Taxonomy 101YP2500X · Licence 2017041286 (MO) |
|---|
Record details
| NPI number | 1801300637 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PLPC |
| Sole proprietor | No |
| NPI enumerated | December 1, 2017 |
| Last updated in NPPES | December 1, 2017 |
| Mailing address | 3101c S Kimbrough Ave, Springfield, MO 65807-5011 |
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