Individual
JACQUELINE ROSE PFEIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3515 S 4TH ST, PROFESSIONAL ASSOCIATION, LEAVENWORTH, KS 66048
(913) 651-8415
(913) 772-8580
Mailing address
18955 WEST 116TH ST, OLATHE, KS 66061
(913) 888-2362
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
866
KS
103T00000X
Psychologist
R0407
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004517
BLUE CROSS BLUE SHIELD GR
KS
01
—
060779
BLUE CROSS BLUE SHIELD
KS
01
—
1049473
CIGNA
—
01
—
22447022
KANSAS CITY BLUE CROSS BL
—
01
—
7154171
AETNA
—
Enumeration date
09/13/2006
Last updated
07/08/2007
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