Individual
MRS. JEANENE MARIE MALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TLMFT
Contact information
Practice address
7381 W 133RD ST, SUITE 260, OVERLAND PARK, KS 66213-4750
(913) 647-8092
Mailing address
9504 W 104TH ST, OVERLAND PARK, KS 66212-5603
(913) 206-8259
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T-LMFT 1261
KS
Other
Enumeration date
09/02/2011
Last updated
09/02/2011
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