Individual
DR. TERESA BETH ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSEDPSYCHOLOGIST
Contact information
Practice address
4200 SOMERSET DR, SUITE 239, PRAIRIE VILLAGE, KS 66208-5217
(816) 363-9500
Mailing address
3965 W 83RD STREET #182, PRAIRIE VILLAGE, KS 66208
(816) 363-9500
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1262
KS
103T00000X
Psychologist
2000167702
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30786016
BCBS
MO
01
—
6183141
UHC UBH
MO
Enumeration date
07/21/2006
Last updated
09/17/2020
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