| Wildwood Cottage | |
|
11212 E 71st St Raytown MO 64133-6801 | |
| (816) 353-5274 | |
| (816) 353-1226 |
| Full Name | Wildwood Cottage |
|---|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
| Location | 11212 E 71st St, Raytown, Missouri |
| Authorized Official Name and Position | Virginia Mae Morgan (ADMINISTRATOR-OWNER) |
| Authorized Official Contact | 8163535274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wildwood Cottage 11212 E 71st St Raytown MO 64133-6801 Ph: (816) 353-5274 | Wildwood Cottage 11212 E 71st St Raytown MO 64133-6801 Ph: (816) 353-5274 |
| NPI Number | 1770757841 |
|---|---|
| Provider Enumeration Date | 04/18/2008 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770757841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (Missouri) | Primary |
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