| NPI | 1851341440 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MELISSA ANN RUSSO Vice President 816-508-4082  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry | 
| Additional Taxonomies | 207R00000X Internal Medicine | 
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-12 | 
| Last Update Date | 2025-07-02 |