Provider Demographics
NPI:1689641185
Name:MEGERMAN, ESTHER (PHD)
Entity Type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:
Last Name:MEGERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7611 STATE LINE RD
Mailing Address - Street 2:135
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-6801
Mailing Address - Country:US
Mailing Address - Phone:816-361-2452
Mailing Address - Fax:816-361-0130
Practice Address - Street 1:7611 STATE LINE RD
Practice Address - Street 2:135
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-6801
Practice Address - Country:US
Practice Address - Phone:816-361-2452
Practice Address - Fax:816-361-0130
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00767103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0002176Medicare ID - Type UnspecifiedPSYCHOLOGIST