Individual
DEREK FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2400 LITTLE BLUE PKWY, INDEPENDENCE, MO 64057
(615) 483-7009
Mailing address
3861 N MULBERRY DR, APT 2403, KANSAS CITY, MO 64116-1877
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2015026806
MO
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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