Thank you for your interest in being added to the Greater Kansas City EMDRIA Regional Network Therapist Membership Directory. Please provide the following information and then email a professional photo (optional) to EMDRGKC@gmail.com.

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* 1. FIRST and LAST NAME

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* 2. PRACTICE / ORGANIZATION NAME

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* 3. WEBSITE ADDRESS, EMAIL ADDRESS, and/or PHONE NUMBER (include only what you want listed in the directory)

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* 4. STREEET ADDRESS, CITY, STATE, and ZIP CODE (if more than one location, include all here)

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* 5. DEGREE and/or LICENSE

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* 6. EMDR THERAPIST CREDENTIALS

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* 7. POPULATION(S) SERVED

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* 8. IN-NETWORK INSURANCE COMPANIES

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* 9. IN-NETWORK EMPLOYEE ASSISTANCE PROGRAMS

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* 10. Please provide a description of your practice using no more than 250 characters. (optional)

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