Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 2008014044 | MO |
Y | 103TC0700X | Clinical Psychologist | 2008014044 | MO |
N | 103TH0100X | Health Service | 2008014044 | MO |
NPI | 1295994135 |
---|---|
Provider Name | Stephen Craig Rooney |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65212-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 06/02/2018 |