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Individual

DR. KEVIN C SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3674
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3674

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
1918
KS
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2010036986
MO
103TC2200X
Clinical Child & Adolescent Psychologist
6155
OH

Other

Enumeration date
07/25/2006
Last updated
09/02/2011
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