Individual
WESLEY WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1719 METROPOLITAN AVE, LEAVENWORTH, KS 66048-1124
(913) 250-5634
Mailing address
5863 NW 72ND ST, KANSAS CITY, MO 64151-1483
(816) 984-8280
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23-260324
KS
Other
Enumeration date
02/24/2023
Last updated
02/24/2023
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