Healthcare Provider Details

I. General information

NPI: 1851079586
Provider Name (Legal Business Name): ATTENTION DISORDERS CLINIC OF KANSAS CITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
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

Practice location:
  • Phone: 518-209-8508
  • Fax:
Mailing address:
  • Phone: 518-209-8508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY HINMAN
Title or Position: CO-OWNER
Credential: PHD
Phone: 913-214-2523