Individual
DR. DAVID R. MOUILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4786 BLACK SWAN DR, SHAWNEE, KS 66216-1235
(913) 962-6810
(913) 962-6810
Mailing address
4786 BLACK SWAN DR, SHAWNEE, KS 66216-1235
(913) 962-6810
(913) 962-6810
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
794
KS
103G00000X
Clinical Neuropsychologist
PYRO327
MO
103TA0400X
Addiction (Substance Use Disorder) Psychologist
794
KS
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PYRO327
MO
103TB0200X
Cognitive & Behavioral Psychologist
794
KS
103TB0200X
Cognitive & Behavioral Psychologist
PYRO327
MO
103TC0700X
Clinical Psychologist
794
KS
103TC0700X
Clinical Psychologist
PYRO327
MO
103TC2200X
Clinical Child & Adolescent Psychologist
794
KS
103TC2200X
Clinical Child & Adolescent Psychologist
PYRO327
MO
103TF0200X
Forensic Psychologist
794
KS
103TF0200X
Forensic Psychologist
PYRO327
MO
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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