Individual
DR. JACQUELINE DIANE NOONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
300 SE 2ND ST, LEES SUMMIT, MO 64063-2759
(816) 404-6170
Mailing address
4145 W 131ST TER, LEAWOOD, KS 66209-4139
(914) 388-7567
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
02989
KS
103TC0700X
Clinical Psychologist
06316
MD
103TC0700X
Clinical Psychologist
Primary
2021004232
MO
103TC0700X
Clinical Psychologist
25876
CA
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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