Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 01129 | MO |
Y | 103T00000X | Psychologist | 01129 | MO |
N | 103TH0100X | Health Service | PY01129 | MO |
NPI | 1558425801 |
---|---|
Provider Name | Dr. Patrick J. Openlander |
First Address | Kirkwood, MO 63122-6166 |
Second Address | Kirkwood, MO 63122-6166 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 25/10/2019 |