Individual
KEVIN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5600 NE ANTIOCH RD, SUITE 214, GLADSTONE, MO 64119
(816) 659-1478
Mailing address
22 GATES DR, PLATTE CITY, MO 64079-9656
(805) 657-5427
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2019012713
MO
Other
Enumeration date
01/04/2017
Last updated
11/21/2024
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