Individual
MR. MICHAEL DAVID CIACCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
421 E 137TH ST, KANSAS CITY, MO 64145
(816) 508-3635
Mailing address
1401 SW MANOR LAKE DR., LEES, MO 64082
(816) 508-3635
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2011033840
MO
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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