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Contact Information

JILLON S VANDER WAL
4801 E LINWOOD BLVD
KANSAS CITY, MO64128-2226
 Phone: 816-861-4700
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Health Service

103TH0100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JILLON S VANDER WAL · (Female)

NPI Number 1467669960
Status Active
Credentials
Entity Individual
Enumeration date 05/16/2007
Last updated 05/31/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • KS License # LP03007
  • MO License # 2004021723
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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