Individual
GAIL CARROLL ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLMHP, PHD
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3674
(816) 346-1382
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2016005680
MO
Other
Enumeration date
11/10/2014
Last updated
08/16/2016
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