Doctor Name: | KELLY LYNN KINCAID |
NPI Number: | 1043488075 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., PLPC |
License Number: | 2008002723 |
Business Practice Address: | 400 E 6th St Parkville, MO - 641523703 |
Business Phone Number: | 8164528910 |
Business Fax Number: | |
Mailing Address: | 400 E 6th St, PARKVILLE |
State: | MO |
Postal Code: | 641523703 |
Phone Number: | 8164528910 |
Fax Number: | |
NPI Enumeration Date: | 02/12/2008 |
NPI Last Update Date: | 03/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2008002723 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |