Individual
MS. KELLY K FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMLP
Contact information
Practice address
212 STATE STREET, FORT SCOTT, KS 66701-2031
(620) 223-5030
(620) 223-1650
Mailing address
212 STATE STREET, PO BOX 704, FORT SCOTT, KS 66701-2031
(620) 223-5030
(620) 223-1650
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LCP 912
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200462390A
—
KS
Enumeration date
01/16/2007
Last updated
08/09/2012
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