Basic Information
| Provider Information | |||||||||
| NPI: | 1346219904 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURRELL | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3150 E ALPINE DR | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658044108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178836453 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2200 E SUNSHINE ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658041883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178811580 | ||||||||
| FaxNumber: | 4178817004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PY01874 | MO | X | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC2200X | X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | 103TF0000X | X | Behavioral Health & Social Service Providers | Psychologist | Family | 103TH0100X | X | Behavioral Health & Social Service Providers | Psychologist | Health Service | 103T00000X | X | Behavioral Health & Social Service Providers | Psychologist | 103TP2701X | X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy |
No ID Information.