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Individual

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Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ED.S

Contact information

Practice address
295 S 10TH ST, KANSAS CITY, KS 66102-5550
(816) 777-8064
Mailing address
295 S 10TH ST, KANSAS CITY, KS 66102-5550
(816) 777-8064

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
3754799592
KS

Other

Enumeration date
06/10/2020
Last updated
11/13/2020
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