Provider Demographics
NPI:1528496197
Name:MCQUERTER, DORIS DENISE (MA, NCC, PLPC)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:DENISE
Last Name:MCQUERTER
Suffix:
Gender:F
Credentials:MA, NCC, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-4658
Mailing Address - Country:US
Mailing Address - Phone:573-620-0639
Mailing Address - Fax:
Practice Address - Street 1:122 BRADLEY DR
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-4658
Practice Address - Country:US
Practice Address - Phone:573-620-0639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013023047101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional