Adservior Mediation Services, LLC

NPI #1255635660 in Raytown, Missouri

Provider Information

NPI Number: 1255635660
Entity Type: Organization
Organization Name: Adservior Mediation Services, LLC
Primary Specialty: Behavior Analyst
Enumeration Date: Dec 28, 2010
Last Updated: Dec 28, 2010

Practice Location

Address: 6220 BLUE RIDGE CUTOFF
Address 2: STE. 204
City: Raytown
State: Missouri
ZIP Code: 64133-3700
Phone: (816) 737-1538

Authorized Official

Name: DR. FLOYD CLARENCE WIGGINS III, P.TH.D/C.M.C
Title: DOCTOR, PASTOR
Phone: (816) 737-1538

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Pastoral — Pastoral	101YP1600X
Counselor - Professional — Professional	101YP2500X
Behavior Analyst	103K00000X	Primary

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