Provider Demographics
NPI:1215064894
Name:DOSCH, JANE A
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:A
Last Name:DOSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:A
Other - Last Name:BRADSHAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:9891 E. FARM RD.160
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742
Mailing Address - Country:US
Mailing Address - Phone:417-753-3475
Mailing Address - Fax:417-882-5517
Practice Address - Street 1:1736 E SUNSHINE ST
Practice Address - Street 2:SUITE 811
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1343
Practice Address - Country:US
Practice Address - Phone:417-882-4485
Practice Address - Fax:417-882-5517
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO756101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional