Individual
MR. JOHN MICHAEL WUBBENHORST SR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
3100 BROADWAY ST, SUITE 1104, KANSAS CITY, MO 64111-2658
(816) 753-3333
(616) 753-7744
Mailing address
3100 BROADWAY ST, SUITE 1104, KANSAS CITY, MO 64111-2658
(816) 753-3333
(616) 753-7744
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY00348
MO
103TC0700X
Clinical Psychologist
Primary
PY00348
MO
103TH0100X
Health Service Psychologist
PY00348
MO
Other
Enumeration date
09/21/2005
Last updated
09/11/2025
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