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Individual

DR. MARY BANKS GREGERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1116 S ESPLANADE ST, LEAVENWORTH, KS 66048-3522
(913) 250-6512
(913) 250-6512
Mailing address
1116 S ESPLANADE ST, LEAVENWORTH, KS 66048-3522
(913) 250-6512
(913) 250-6512

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810002585
VA
103T00000X
Psychologist
2011019793
MO

Other

Enumeration date
04/19/2007
Last updated
01/25/2012
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