Organization
KASEY GRASS PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KASEY NICOLE GRASS PH.D. (OWNER/PSYCHOLOGIST)
(501) 993-2274
Entity
Organization
Contact information
Practice address
2401 W GRAND ST, SPRINGFIELD, MO 65802-4967
(501) 993-2274
(888) 389-4091
Mailing address
2761 E MELBOURNE RD, SPRINGFIELD, MO 65804-5257
(501) 993-2274
(888) 389-4091
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2011019654
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073805909
—
MO
Enumeration date
09/13/2012
Last updated
11/15/2012
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