Individual
CARLA MARIE INGEBORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 W 41ST ST, KANSAS CITY, MO 64111-4407
(816) 510-3209
Mailing address
4506 TERRACE ST, KANSAS CITY, MO 64111-4239
(816) 510-3209
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2012040156
MO
106H00000X
Marriage & Family Therapist
2440
KS
Other
Enumeration date
01/30/2013
Last updated
01/30/2013
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