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M A Mirza, Llc
Prescribing (Medical) Psychologist in Lees Summit, Missouri
NPI 1376757617

M A Mirza, Llc is a Prescribing (Medical) Psychologist based in Lees Summit, MO and is specialized in Prescribing (Medical). M A Mirza, Llc practices in Lees Summit, MO. The NPI Number for M A Mirza, Llc is 1376757617 and holds a License No. RICIO (Missouri).

The current practice location address for M A Mirza, Llc is 4045 Ne Lakewood Way, Lees Summit, MO and can be reached out via phone at 816-886-2184 and via fax at 816-886-2397.

Location: 4045 Ne Lakewood Way, Lees Summit, MO, 64064-1799
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1376757617
Provider Name
M A Mirza, Llc
Credential
Provider Entity Type
Organization
Address
4045 Ne Lakewood Way, Lees Summit, MO, 64064-1799
Phone Number
816-886-2184
Fax Number
816-886-2397
Provider Enumeration Date
05/09/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4045 Ne Lakewood Way
City
Lees Summit
State
Missouri
Zip
64064-1799
Phone Number
816-886-2184
Fax Number
816-886-2397
person
Provider Business Mailing Address Details
Address
4045 Ne Lakewood Way
City
Lees Summit
State
Missouri
Zip
64064-1799
Phone Number
816-886-2184
Fax Number
816-886-2397
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Prescribing (Medical)
Taxonomy
103TP0016X
License No.
RICIO (Missouri)
Definition
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
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