| NPI | 1528183159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD JOHN SULLIVAN Member 913-451-2843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS LP-0436) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2010-12-29 |