Healthcare Provider Details
I. General information
NPI: 1841381803
Provider Name (Legal Business Name): DEANNA KRAUS ZEILMANN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/27/2006
Last Update Date: 05/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1170 W KANSAS ST WESTOWNE OFFICE PARK, BUILDING 10
LIBERTY MO
64068-2036
US
IV. Provider business mailing address
1170 W KANSAS ST WESTOWNE OFFICE PARK, BUILDING 10
LIBERTY MO
64068-2036
US
V. Phone/Fax
- Phone: 816-781-6634
- Fax: 816-407-7706
- Phone: 816-781-6634
- Fax: 816-407-7706
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 2002020079 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TP2701X |
| Taxonomy | Group Psychotherapy Psychologist |
| License Number | 2002020079 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: