| Doctor Name: | MRS. CONNIE MAE PUTTHOFF |
| NPI Number: | 1053464297 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LSCSW |
| License Number: | 2479 |
| Business Practice Address: | 901 Ne Independence Ave Lees Summit, MO - 640865544 |
| Business Phone Number: | 8163473017 |
| Business Fax Number: | 8162468207 |
| Mailing Address: | 901 Ne Independence Ave, LEES SUMMIT |
| State: | MO |
| Postal Code: | 640865544 |
| Phone Number: | 8163473017 |
| Fax Number: | 8162468207 |
| NPI Enumeration Date: | 01/19/2007 |
| NPI Last Update Date: | 04/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2479 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |