Organization
MARY J. YANICS, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY JEANNE YANICS PH.D. (OWNER/SINGLE MEMBER)
(913) 341-9444
Entity
Organization
Contact information
Practice address
8340 MISSION RD, SUITE 228, PRAIRIE VILLAGE, KS 66206-1355
(913) 341-9444
(913) 341-9444
Mailing address
8340 MISSION RD, SUITE 228, PRAIRIE VILLAGE, KS 66206-1355
(913) 341-9444
(913) 341-9444
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 985
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27632034
BLUE CROSS/BLUE SHIELD OF KANSAS CITY
—
Enumeration date
03/20/2012
Last updated
03/20/2012
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