Healthcare Provider Details

I. General information

NPI: 1699630863
Provider Name (Legal Business Name): HAMDI COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 MARTIN LUTHER KING JR BLVD
KANSAS CITY MO
64130
US

IV. Provider business mailing address

4400 MARTIN LUTHER KING JR BLVD
KANSAS CITY MO
64130
US

V. Phone/Fax

Practice location:
  • Phone: 816-994-5693
  • Fax:
Mailing address:
  • Phone: 816-994-5693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-501450
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: