Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 2014007649 | MO |
NPI | 1003235961 |
---|---|
Provider Name | Kajal Kaul |
First Address | Saint Robert, MO 65584-4892 |
Second Address | Lebanon, MO 65536-4669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 08/04/2014 |