Healthcare Provider Details

I. General information

NPI: 1518681626
Provider Name (Legal Business Name): LAURA BLANKENSHIP MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/03/2022
Certification Date: 10/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8150 WORNALL RD
KANSAS CITY MO
64114-5806
US

IV. Provider business mailing address

3635 WARWICK BLVD APT 10
KANSAS CITY MO
64111-1478
US

V. Phone/Fax

Practice location:
  • Phone: 816-508-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: