Healthcare Provider Details

I. General information

NPI: 1891644894
Provider Name (Legal Business Name): TAMARA ATWELL RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 NE COLBERN RD # 200
LEES SUMMIT MO
64086-4711
US

IV. Provider business mailing address

520 NE COLBERN RD # 200
LEES SUMMIT MO
64086-4711
US

V. Phone/Fax

Practice location:
  • Phone: 816-643-4959
  • Fax: 816-282-2680
Mailing address:
  • Phone: 816-643-4959
  • Fax: 816-282-2680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-465919
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: