Healthcare Provider Details

I. General information

NPI: 1164781076
Provider Name (Legal Business Name): MRS. DESIREE DAWN BRASHEAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DESIREE ANDREWS

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 S FOUNTAIN DR
OLATHE KS
66061-7206
US

IV. Provider business mailing address

4721 S CLIFF AVE STE 103
INDEPENDENCE MO
64055-6969
US

V. Phone/Fax

Practice location:
  • Phone: 913-379-1656
  • Fax: 800-687-5070
Mailing address:
  • Phone: 816-608-1956
  • Fax: 800-687-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: