Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 2009030746 | MO |
NPI | 1023336765 |
---|---|
Provider Name | Dr. Farrell S. Weiers |
First Address | Kansas City, MO 64153-3720 |
Second Address | Kansas City, MO 64153-3720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2010 |
Last Update Date | 05/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43714011 | BLUE CROSS BLUE SHIELD KANSAS CITY (01) |