| NPI | 1255756144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN PROHASKA Owner 913-226-8270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 2124) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: KS 2124) |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2014-02-28 |