Individual
KENNETH E CALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2751 THOMAS DR, CAPE GIRARDEAU, MO 63701-2131
(573) 334-2889
(573) 651-9152
Mailing address
2751 THOMAS DR, CAPE GIRARDEAU, MO 63701-2131
(573) 334-2889
(573) 651-9152
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
00699
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4558
BCBS
MO
Enumeration date
05/04/2007
Last updated
07/08/2007
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