Jacob Fantin, PLP

NPI #1538883459 in Monett, Missouri

Provider Information

NPI Number: 1538883459
Entity Type: Individual
Name: Jacob Fantin, PLP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - Clinical
Credential: PLP
Enumeration Date: Oct 4, 2022
Last Updated: Oct 4, 2022

Practice Location

Address: 1701 N CENTRAL AVE
City: Monett
State: Missouri
ZIP Code: 65708-9999
Phone: (417) 476-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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