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General NPI Number Information
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NPI Number | 1245097724
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Entity Type | Individual
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Provider Name | KIMBERLY SHEPHERD
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Gender | Female
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 300 W 19TH TER
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City | KANSAS CITY
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State | MO
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Zip | 64108-2026
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Country | US
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Telephone | 816-404-5709
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Fax |
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Provider Business Mailing Address
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Address Line | 10222 N LEWIS AVE
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City | KANSAS CITY
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State | MO
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Zip | 64157-7948
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Country | US
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Telephone | 402-690-3015
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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