Individual
MRS. CONNIE MAE PUTTHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
901 NE INDEPENDENCE AVE, LEES SUMMIT, MO 64086-5544
(816) 347-3017
(816) 246-8207
Mailing address
901 NE INDEPENDENCE AVE, LEES SUMMIT, MO 64086-5544
(816) 347-3017
(816) 246-8207
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2004025819
MO
1041C0700X
Clinical Social Worker
2479
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098080A
—
KS
01
—
100098080C
SED WAIVER
KS
Enumeration date
01/19/2007
Last updated
04/26/2016
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