| NPI | 1497427496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH GREGORY BURKE Member 816-289-2687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2022-05-11 |