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Individual

MARY K RICHARDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
4901 MAIN ST, STE. 401, KANSAS CITY, MO 64112-2646
(816) 753-7071
(816) 753-8189
Mailing address
4901 MAIN ST, STE. 401, KANSAS CITY, MO 64112-2646
(816) 753-7071
(816) 753-8189

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 01363
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15126012
BC/BS KC
MO
01
280217
VALUE OPTIONS
01
567219
BC/BS KS
KS
01
69352
CIGNA
Enumeration date
07/18/2006
Last updated
07/08/2007
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