Organization
GRAY HORSE MENTAL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY AYCOCK LPC (OWNER, PRACTITIONER)
(913) 638-1246
Entity
Organization
Contact information
Practice address
3500 N 99TH ST, KANSAS CITY, KS 66109
(913) 638-1246
Mailing address
4917 WOODSTOCK ST, SHAWNEE, KS 66218-9141
(913) 638-1246
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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