1801814421

Everything you always wanted to know about RICHARDSON K MARY PH.D. but were afraid to ask.

RICHARDSON K MARY PH.D.

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Provider Last Name Provider Middle Name Provider First Name Provider Credential
RICHARDSON K MARY PH.D.
Gender:
Female
Enumeration date:
2006-07-18
Last update date:
2007-07-08
Current as of:
2007-08-28
Is sole proprietor?:
Yes
Is organization subpart?:
Not Answered
In PECOS?:
No
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Identifiers

identifier description issuer state active
R61440 Medicare UPIN none none 1
15126012 Other BC/BS KC MO 1
0001101 Medicare ID-Type Undpecified none none 1
280217 Other VALUE OPTIONS none 1
69352 Other CIGNA none 1
567219 Other BC/BS KS KS 1

Taxonomies

Taxonomy State License Number Primary?
103T00000X Psychologist MO PY 01363

Phone Numbers

Type Number
Mailing Address Telephone Number 8167537071
Practice Location Address Telephone Number 8167537071
Mailing Address Fax Number 8167538189
Practice Location Address Fax Number 8167538189

Addresses

Type Address City State Postal Country
Mailing Address 4901 MAIN ST STE. 401 KANSAS CITY MO 64112 MO
Practice Location Address 4901 MAIN ST STE. 401 KANSAS CITY MO 64112 MO

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NPI Name Address State City Identifier types that matches
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