Individual
DR. JERRY L WYCKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7501 COLLEGE BLVD., SUITE 250, OVERLAND PARK, KS 66210-1944
(913) 451-8550
(913) 469-5266
Mailing address
7501 COLLEGE BLVD., SUITE 250, OVERLAND PARK, KS 66210-1944
(913) 451-8550
(913) 469-5266
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
R0309
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18879014
BCBS KC
KS
01
—
18879014
BCBS KC
MO
Enumeration date
10/14/2006
Last updated
11/06/2008
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