Individual
CARRON ELLSPERMANN MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, RPT
Contact information
Practice address
4500 COLLEGE BLVD, SUITE 304, OVERLAND PARK, KS 66211-1760
(913) 338-0400
Mailing address
9915 ENSLEY LN, LEAWOOD, KS 66206-2460
(913) 515-6927
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2436
KS
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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