Provider Demographics
NPI:1265631527
Name:WEXLER, MICAELA PATRICIA (DO)
Entity Type:Individual
Prefix:
First Name:MICAELA
Middle Name:PATRICIA
Last Name:WEXLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MICAELA
Other - Middle Name:PATRICIA
Other - Last Name:DONALDSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:12306 PAWNEE LN
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1407
Mailing Address - Country:US
Mailing Address - Phone:913-948-0688
Mailing Address - Fax:913-261-9634
Practice Address - Street 1:4203 BOOTH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-3116
Practice Address - Country:US
Practice Address - Phone:913-948-0688
Practice Address - Fax:913-261-9634
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20100054312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry