Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | LP0864 | KS |
NPI | 1104808682 |
---|---|
Provider Name | Kathy Anne Pearce |
First Address | Newton, KS 67114 |
Second Address | Newton, KS 67114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 08/07/2007 |