Individual
CAROLINE MALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9100 MISSION RD, PRAIRIE VILLAGE, KS 66206-1714
(913) 261-9290
Mailing address
3965 W 83RD ST # 157, PRAIRIE VILLAGE, KS 66208-5308
(913) 261-9290
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
KS
Other
Enumeration date
03/05/2026
Last updated
03/05/2026
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