Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 2016016296 | MO |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 20792 | CA |
NPI | 1053558304 |
---|---|
Provider Name | Dr. Leslee Throckmorton Belzer |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64111-2659 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2009 |
Last Update Date | 03/06/2016 |