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Individual

DR. SUSAN MARIE SOUTHWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
310 S PLATTE CLAY WAY, SUITE C, KEARNEY, MO 64060-8797
(816) 914-5322
(816) 628-5452
Mailing address
310 S PLATTE CLAY WAY, SUITE C, KEARNEY, MO 64060-8797
(816) 914-5322
(816) 628-5452

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY01928
MO

Other

Enumeration date
12/20/2007
Last updated
07/12/2013
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