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General NPI Number Information
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NPI Number | 1497874143
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL DEVELOPMENT SERVICES
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 413 E SANTA FE ST SUITE B
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City | OLATHE
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State | KS
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Zip | 66061-3445
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Country | US
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Telephone | 913-782-4996
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Fax | 913-782-4997
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Provider Business Mailing Address
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Address Line | 413 E SANTA FE ST SUITE B
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City | OLATHE
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State | KS
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Zip | 66061-3445
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Country | US
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Telephone | 913-782-4996
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Fax | 913-782-4997
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JAMES J KHALILI
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Credential | PH. D.
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Telephone | 913-782-4996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 275
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License Number State | KS
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