Jacob Fantin, PLP

NPI 1538883459 · on the registry since 2022

Practice

Address: 1701 N Central Ave
Monett, MO 65708
Phone: (417) 476-1000
Fax: (417) 476-1082
Organisation at this address: Clark Community Mental Health Center
Clark Community Mental Health Center
Clark Community Mental Health Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 19

Registry record

Primary taxonomy: 103TC0700X
103TC0700X
Licence states on file: MO
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2022-10-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri