Healthcare Provider Details

I. General information

NPI: 1396467601
Provider Name (Legal Business Name): GHINA FARES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 W 110TH ST STE 330
OVERLAND PARK KS
66211-1798
US

IV. Provider business mailing address

7349 QUIVIRA RD APT 3305
SHAWNEE KS
66216-3727
US

V. Phone/Fax

Practice location:
  • Phone: 913-521-9090
  • Fax:
Mailing address:
  • Phone: 816-946-4819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2026026893
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: