Individual
ROGER DELOACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2020 S M-291 HWY, INDEPENDENCE, MO 64057-1043
(816) 461-0266
Mailing address
400 E 6TH ST, PARKVILLE, MO 64152-3703
(816) 587-4100
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2014044592
MO
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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