Individual
AILEEN DEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 NE INDEPENDENCE AVE, LEES SUMMIT, MO 64086-5544
(816) 347-3281
Mailing address
7110 LACKMAN RD, APT 305, SHAWNEE, KS 66217-8321
(479) 685-1915
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
2011035320
MO
Other
Enumeration date
12/03/2013
Last updated
12/03/2013
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