Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 02991-T | KS |
NPI | 1205493640 |
---|---|
Provider Name | Kristin Gallaway |
First Address | Overland Park, KS 66212 |
Second Address | Overland Park, KS 66212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2019 |
Last Update Date | 29/11/2021 |