Individual
GEORGE DAVISON GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
15901 E 43RD ST S, INDEPENDENCE, MO 64055-5044
(816) 373-4191
Mailing address
15901 E 43RD ST S, INDEPENDENCE, MO 64055-5044
(816) 373-4191
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
2006007591
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006007591
LCSW
MO
Enumeration date
12/29/2010
Last updated
12/29/2010
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