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Individual

MISS CULLE L. VANDE GARDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, CAC

Contact information

Practice address
4104 CENTRAL ST, KANSAS CITY, MO 64111-2307
(913) 706-5214
Mailing address
4104 CENTRAL ST, KANSAS CITY, MO 64111-2307
(913) 706-5214

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2004009155
MO
1041C0700X
Clinical Social Worker
2419
KS
1041C0700X
Clinical Social Worker
992527
CO

Other

Enumeration date
02/06/2007
Last updated
07/08/2007
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