| NPI | 1003671348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY CLEMETSON Director Of Billing/ Credentialing 913-475-7713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |