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General NPI Number Information
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NPI Number | 1194922112
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Entity Type | Individual
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Provider Name | LINDA BUXBAUM BASS PHD, LCMFT
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Gender | Female
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 155 S 18TH ST SUITE 222
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City | KANSAS CITY
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State | KS
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Zip | 66102-5642
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Country | US
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Telephone | 913-963-0784
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Fax |
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Provider Business Mailing Address
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Address Line | 307 S 9TH ST
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City | SAINT JOSEPH
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State | MO
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Zip | 64501-2714
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Country | US
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Telephone | 619-920-2677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 358
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License Number State | KS
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