Individual
MARCY LEIGH VANDAMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 701-5200
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 701-5200
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
03234
KS
103G00000X
Clinical Neuropsychologist
2023036589
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03234
PSYCHOLOGY LICENSE
KS
01
—
1059
PSYCHOLOGY LICENSE
NE
01
—
110552
PSYCHOLOGY LICENSE
IA
01
—
2023036589
PSYCHOLOGY LICENSE
MO
Enumeration date
08/30/2018
Last updated
09/27/2023
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