| Theresa Coddington, Phd | |
|
11011 King St Ste 105 Overland Park KS 66210-1203 | |
| (913) 291-4666 | |
| Not Available |
| Full Name | Theresa Coddington, Phd |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 11011 King St Ste 105, Overland Park, Kansas |
| Authorized Official Name and Position | Theresa Coddington (OWNER) |
| Authorized Official Contact | 9132914666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa Coddington, Phd 11011 King St Ste 105 Overland Park KS 66210-1203 Ph: (913) 291-4666 | Theresa Coddington, Phd 11011 King St Ste 105 Overland Park KS 66210-1203 Ph: (913) 291-4666 |
| NPI Number | 1346889664 |
|---|---|
| Provider Enumeration Date | 01/03/2020 |
| Last Update Date | 07/27/2020 |
| Certification Date | 07/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346889664 | NPI | - | NPPES |
| 100384950 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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