| Kccat | |
|
10555 Marty St Overland Park KS 66212-2555 | |
| (913) 649-8820 | |
| (913) 649-8823 |
| Full Name | Kccat |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 10555 Marty St, Overland Park, Kansas |
| Authorized Official Name and Position | Ryan Hale-gleason (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 9139566201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kccat 10555 Marty St Overland Park KS 66212-2555 Ph: (913) 649-8820 | Kccat 10555 Marty St Overland Park KS 66212-2555 Ph: (913) 649-8820 |
| NPI Number | 1770811309 |
|---|---|
| Provider Enumeration Date | 11/19/2009 |
| Last Update Date | 10/12/2020 |
| Certification Date | 10/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770811309 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | (Kansas) | Primary |
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