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General NPI Number Information
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NPI Number | 1164244398
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Entity Type | Individual
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Provider Name | MINDI M SHUPE
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Gender | Female
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 2700 E 18TH ST
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City | KANSAS CITY
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State | MO
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Zip | 64127-2602
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Country | US
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Telephone | 816-241-3994
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Fax |
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Provider Business Mailing Address
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Address Line | 7150 N FIELDSTONE CT
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City | PARKVILLE
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State | MO
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Zip | 64152-4923
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Country | US
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Telephone | 913-486-8807
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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