Wildwood Cottage

NPI #1770757841 in Raytown, Missouri

Provider Information

NPI Number: 1770757841
Entity Type: Organization
Organization Name: Wildwood Cottage
Subpart: Yes (part of a larger organization)
Parent Organization: KMW,INC.
Primary Specialty: Psychologist - Intellectual & Developmental Disabilities
Enumeration Date: Apr 18, 2008
Last Updated: Apr 20, 2008

Practice Location

Address: 11212 E 71ST ST
City: Raytown
State: Missouri
ZIP Code: 64133-6801
Phone: (816) 353-5274

Authorized Official

Name: MRS. VIRGINIA MAE MORGAN
Title: ADMINISTRATOR-OWNER
Phone: (816) 353-5274

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Intellectual & Developmental Disabilities — Intellectual & Developmental Disabilities	103TM1800X	Primary

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