Organization
ADSERVIOR MEDIATION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FLOYD CLARENCE WIGGINS III P.TH.D/C.M.C (DOCTOR, PASTOR)
(816) 737-1538
Entity
Organization
Contact information
Practice address
6220 BLUE RIDGE CUTOFF, STE. 204, RAYTOWN, MO 64133-3700
(816) 737-1538
Mailing address
PO BOX 9471, RAYTOWN, MO 64133-0271
(816) 737-1538
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/28/2010
Last updated
12/28/2010
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