Healthcare Provider Details

I. General information

NPI: 1720144298
Provider Name (Legal Business Name): SHU-FEN SHIH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 W 70TH TER
KANSAS CITY MO
64113-2052
US

IV. Provider business mailing address

461 W 70TH TER
KANSAS CITY MO
64113-2052
US

V. Phone/Fax

Practice location:
  • Phone: 816-523-7884
  • Fax:
Mailing address:
  • Phone: 816-523-7884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2004033833
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1368
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: