Individual
KERRY KATHLEEN PROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2016034058
MO
103TC2200X
Clinical Child & Adolescent Psychologist
2610
KS
Other
Enumeration date
09/19/2016
Last updated
12/18/2025
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