Individual
MR. CARL STANLEY MARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
901 NE INDEPENDENCE AVE, LEES SUMMIT, MO 64086-5544
(816) 347-3286
(816) 246-8207
Mailing address
3524 NE LACEWOOD CIR, LEES SUMMIT, MO 64064-1853
(816) 478-6111
(816) 246-8207
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1108
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108
PSYCHOLOGIST LICENSE
MO
Enumeration date
08/09/2006
Last updated
07/08/2007
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