Liese, Bruce S

Liese, Bruce S is an individual health care provider with primary practice located at 3901 Rainbow Blvd Ms 4017, Kansas City KS 66160-0001. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Liese, Bruce S can be contacted via phone (913) 588-1944.

Contact Information

Primary practice address
3901 Rainbow Blvd Ms 4017 Kansas City KS 66160-0001
Phone: (913) 588-1944
Fax: (913) 588-2496
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 0616 Kansas

Profile Details

NPI number 1770676223
LBN Legal business name Liese, Bruce S
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Jul 16th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770676223 NPPES
Missouri MEDICAID 498634500
Missouri Other 110150074
Missouri Other 11784036
Missouri MEDICAID 4957111501

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