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NPI Code Detail

MEDICARE: DR. ANDREW J KNOOP PHD

MEDICARE: DR. ANDREW J KNOOP PHD
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
1103TS0200XSchool Psychologist2005004518MO
2103TC2200XClinical Child & Adolescent Psychologist2005004518MO

General Provider Information

NPI Number : 1235182866
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW J KNOOP PHD
Provider Business Mailing Address
First Line : PO BOX 843966
Second Line :
City : KANSAS CITY
State : MO
Zip : 64184-3966
Country : US
Telephone Number : 573-884-3300
Fax Number : 573-884-0943
Provider Business Practice Location Address
First Line : 205 PORTLAND ST
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-6521
Country : US
Telephone Number : 573-884-6052
Fax Number : 573-884-1151
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 10/05/2022

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