Susan Southworth, Psy.d. LLC

NPI #1750834701 in Kearney, Missouri

Provider Information

NPI Number: 1750834701
Entity Type: Organization
Organization Name: Susan Southworth, Psy.d. LLC
Primary Specialty: Psychologist - Clinical
Enumeration Date: Jul 26, 2016
Last Updated: Jul 26, 2016

Practice Location

Address: 302 S PLATTE CLAY WAY
Address 2: SUITE 103
City: Kearney
State: Missouri
ZIP Code: 64060-8500
Phone: (816) 903-3800

Authorized Official

Name: DR. SUSAN MARIE SOUTHWORTH, PSY.D.
Title: CLINICAL PSYCHOLOGIST
Phone: (816) 903-3800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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