Healthcare Provider Details

I. General information

NPI: 1790950418
Provider Name (Legal Business Name): DEBORAH R GARNETT, PH.D. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 10/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9229 WARD PKWY SUITE 225
KANSAS CITY MO
64114-3326
US

IV. Provider business mailing address

9229 WARD PKWY SUITE 225
KANSAS CITY MO
64114-3326
US

V. Phone/Fax

Practice location:
  • Phone: 816-444-5511
  • Fax: 816-822-8058
Mailing address:
  • Phone: 816-444-5511
  • Fax: 816-822-8058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number01586
License Number StateMO

VIII. Authorized Official

Name: DR. DEBORAH RUTH GARNETT
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 816-444-5511