MEDICARE: DR. RICHARD ABLOFF PHD ABPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	00694	MO

General Provider Information

NPI Number	:	1528270683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ABLOFF PHD ABPP

Provider Business Mailing Address
First Line	:	6306 WALNUT ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113
Country	:	US
Telephone Number	:	816-444-7890
Fax Number	:	816-444-8802

Provider Business Practice Location Address
First Line	:	6306 WALNUT ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113
Country	:	US
Telephone Number	:	816-444-7890
Fax Number	:	816-444-8802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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