Provider Demographics
NPI:1053465906
Name:EGNER JESTER, GLORIA A (LCSW KS LCSW MO)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:A
Last Name:EGNER JESTER
Suffix:
Gender:F
Credentials:LCSW KS LCSW MO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4700 S CEDARCREST CT
Mailing Address - Street 2:SUITE 12
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055
Mailing Address - Country:US
Mailing Address - Phone:816-350-7179
Mailing Address - Fax:816-350-3962
Practice Address - Street 1:4700 S CEDARCREST CT
Practice Address - Street 2:SUITE 12
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055
Practice Address - Country:US
Practice Address - Phone:816-350-7179
Practice Address - Fax:816-350-3962
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20001535631041C0700X
KS14541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical