Healthcare Provider Details
I. General information
NPI: 1639997703
Provider Name (Legal Business Name): KANSAS CITY TESTING AND ASSESSMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2024
Last Update Date: 09/28/2024
Certification Date: 09/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6315 WALNUT ST
KANSAS CITY MO
64113-2313
US
IV. Provider business mailing address
6315 WALNUT ST
KANSAS CITY MO
64113-2313
US
V. Phone/Fax
- Phone: 816-926-0642
- Fax:
- Phone: 816-926-0642
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIMBERLY
HINMAN
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 816-926-0642