Individual
DR. TAMARA CODER MIKINSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
10965 GRANADA LANE, SUITE 101, OVERLAND PARK, KS 66211-1412
(913) 777-6665
(913) 345-0090
Mailing address
P.O. BOX 272, DESOTO, KS 66018
(816) 223-1407
(913) 345-0090
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
01693
MO
103T00000X
Psychologist
6301015897
MI
103T00000X
Psychologist
Primary
884
KS
103T00000X
Psychologist
—
—
103TC1900X
Counseling Psychologist
884
KS
103TC1900X
Counseling Psychologist
—
—
103TF0000X
Family Psychologist
884
KS
103TP2701X
Group Psychotherapy Psychologist
884
KS
Other
Enumeration date
02/19/2007
Last updated
10/21/2020
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