Individual
MICHELE HERZER MADDUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2010033138
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093024424
—
MO
05
—
200678230A
—
KS
Enumeration date
10/04/2010
Last updated
08/05/2013
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