Basic Information
| Provider Information | |||||||||
| NPI: | 1457725269 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WISDOM | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | LEA | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2136 SW RAMBLING VINE RD | ||||||||
| Address2: | |||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640824140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8166825955 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10550 MARTY ST | ||||||||
| Address2: | ASAP EXPERT COUNSELING LLC | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662122557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9139526696 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2015 | ||||||||
| LastUpdateDate: | 11/17/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | LPC 2856 | KS | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.