Individual
JACOB MICHAEL MAGGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLMFT
Contact information
Practice address
18600 E 37TH TER S, INDEPENDENCE, MO 64057-1707
(816) 200-7254
Mailing address
18600 E 37TH TER S, INDEPENDENCE, MO 64057-1707
(816) 200-7254
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2022036664
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022036664
PLMFT LICENSE#
MO
Enumeration date
05/06/2021
Last updated
10/04/2022
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