| None | |
|
39055 E State Highway 146 Gilman City MO 64642-7215 | |
| (816) 351-6997 | |
| Not Available |
| Full Name | None |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 39055 E State Highway 146, Gilman City, Missouri |
| Authorized Official Name and Position | Mary M Brant (OWNER) |
| Authorized Official Contact | 8163516997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 39055 E State Highway 146 Gilman City MO 64642-7215 Ph: (816) 351-6997 | None 39055 E State Highway 146 Gilman City MO 64642-7215 Ph: (816) 351-6997 |
| NPI Number | 1275838989 |
|---|---|
| Provider Enumeration Date | 01/11/2011 |
| Last Update Date | 01/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275838989 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2007000444 (Missouri) | Primary |