Organization
JAG THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE A GIBSON M.S.W. (MANAGER/ THERAPIST)
(816) 455-7450
Entity
Organization
Contact information
Practice address
4401 N.E. VIVION RD, SUITE 203, KANSAS CITY, MO 64119-2800
(816) 455-7450
Mailing address
4401 N.E. VIVION RD, SUITE 203, KANSAS CITY, MO 64119-2800
(816) 455-7450
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000712
MO
Other
Enumeration date
06/07/2006
Last updated
09/24/2007
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