Healthcare Provider Details

I. General information

NPI: 1003585761
Provider Name (Legal Business Name): NAYALISA M CUEVAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 INDIAN CREEK PKWY STE 510
OVERLAND PARK KS
66210-2090
US

IV. Provider business mailing address

3705 BENTON BLVD
KANSAS CITY MO
64128-2516
US

V. Phone/Fax

Practice location:
  • Phone: 773-480-3547
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: