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Provider Information for 1497024400


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WESLEY RAYMOND HIRST L.P.C.


Sex: Male

NPI: 1497024400
Last Updated: 2011-12-20
Certification Date:

Details

NameValue
NPI1497024400
Enumeration Date2011-12-20
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 5608 CANDLEBERRY DR
SAINT JOSEPH, MO 64503-2009
United States

Phone: 816-617-2476 | Fax:816-671-4022
 
Primary Practice Address 5608 CANDLEBERRY DR
SAINT JOSEPH, MO 64503-2009
United States

Phone: 816-617-2476 | Fax:816-671-4022
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalMO000440