MS. Jeannie Gloria Dake

NPI #1144349259 in Rolla, Missouri

Provider Information

NPI Number: 1144349259
Entity Type: Individual
Name: MS. Jeannie Gloria Dake
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 28, 2007
Last Updated: Jul 9, 2007

Practice Location

Address: 1101 STROBACH ST
City: Rolla
State: Missouri
ZIP Code: 65401-4243
Phone: (573) 364-4667

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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