Individual
RANDAL DEMASTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
421 E 137TH ST, KANSAS CITY, MO 64145-1455
(816) 508-3638
Mailing address
421 E 137TH ST, KANSAS CITY, MO 64145-1455
(816) 508-3638
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1999135679
MO
101YP1600X
Pastoral Counselor
6015
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494845811
—
MO
Enumeration date
10/04/2006
Last updated
03/26/2009
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