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NPI Code Detail

MEDICARE: TONJA J SPEER MA

MEDICARE: TONJA J SPEER MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistLCP 068KS

General Provider Information

NPI Number : 1194874438
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONJA J SPEER MA
Provider Business Mailing Address
First Line : 7810 N REVERE DR
Second Line :
City : KANSAS CITY
State : MO
Zip : 64151-4422
Country : US
Telephone Number : 913-328-4696
Fax Number :
Provider Business Practice Location Address
First Line : 7840 WASHINGTON AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66112-2152
Country : US
Telephone Number : 913-328-4696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 07/08/2007

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