Healthcare Provider Details

I. General information

NPI: 1083171276
Provider Name (Legal Business Name): EMILY FOLTZ LLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8080 WARD PKWY STE 407
KANSAS CITY MO
64114-2020
US

IV. Provider business mailing address

8080 WARD PKWY STE 407
KANSAS CITY MO
64114-2020
US

V. Phone/Fax

Practice location:
  • Phone: 816-895-2859
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2015013197
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: