Provider Demographics
NPI:1477709491
Name:KAMAL, TERESA DIANE (MD DO)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:DIANE
Last Name:KAMAL
Suffix:
Gender:F
Credentials:MD DO
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:DIANE
Other - Last Name:ROLF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CERTNURSE AISSITANT
Mailing Address - Street 1:8509 E 93RD ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64138-4614
Mailing Address - Country:US
Mailing Address - Phone:816-914-7517
Mailing Address - Fax:
Practice Address - Street 1:8509 E 93RD ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-4614
Practice Address - Country:US
Practice Address - Phone:816-914-7517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-10
Last Update Date:2008-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health