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Individual

MR. MARK S. SIEGMUND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC, LCPC

Contact information

Practice address
480 S ROGERS RD, OLATHE, KS 66062-1706
(913) 324-3608
Mailing address
8736 SUNRAY DR., LENEXA, KS 66227
(913) 832-4320

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
000860
MO
101YP2500X
Professional Counselor
Primary
310
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
493399133
MO
Enumeration date
12/21/2006
Last updated
09/27/2011
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