Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | MO |
NPI | 1063036606 |
---|---|
Provider Name | Joseph Manuel Myers |
First Address | Kansas City, MO 64109-1246 |
Second Address | Kansas City, MO 64109-1538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2020 |
Last Update Date | 29/05/2020 |