Individual
DR. KEVIN MICHAEL WHISMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1027 S MAIN ST, SUITE 308, JOPLIN, MO 64801-4527
(417) 385-3491
(417) 429-2340
Mailing address
1027 S MAIN ST, SUITE 308, JOPLIN, MO 64801-4527
(417) 385-3491
(417) 429-2340
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2000175013
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200078010A
—
OK
05
—
495184715
—
MO
Enumeration date
09/26/2006
Last updated
04/25/2012
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