Individual
MACY GRACE SISSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11115 BENNINGTON AVE, KANSAS CITY, MO 64134-3106
(816) 316-7740
Mailing address
11115 BENNINGTON AVE, KANSAS CITY, MO 64134-3106
(618) 616-9430
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/29/2023
Last updated
09/29/2023
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