Individual
WESLEY MAX LEDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7524 EATON ST, PRAIRIE VILLAGE, KS 66208-3610
(913) 634-5199
Mailing address
7524 EATON ST, PRAIRIE VILLAGE, KS 66208-3610
(913) 634-5199
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
000290
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493240121
—
MO
Enumeration date
03/15/2007
Last updated
09/23/2009
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