Provider Demographics
NPI:1922416015
Name:SPRESSER, CARRIE DIANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:DIANNE
Last Name:SPRESSER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:DIANNE
Other - Last Name:SPRESSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:8448 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-4417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4330 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 2180
Practice Address - City:FAIRWAY
Practice Address - State:KS
Practice Address - Zip Code:66205-2522
Practice Address - Country:US
Practice Address - Phone:913-588-6968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-01
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA073888103G00000X
KS2362103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist