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Individual

JUSTIN LASATER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LMLP

Contact information

Practice address
5200 W 94TH TER, #200, PRAIRIE VILLAGE, KS 66207-2522
(913) 383-8100
Mailing address
5200 W 94TH TER, #200, PRAIRIE VILLAGE, KS 66207-2522
(913) 383-8100

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2891
KS

Other

Enumeration date
01/09/2016
Last updated
11/15/2018
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