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General NPI Number Information
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NPI Number | 1316092356
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Entity Type | Individual
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Provider Name | PRIYA R. SAMUEL LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8000 W 127TH ST
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City | OVERLAND PARK
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State | KS
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Zip | 66213-2714
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Country | US
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Telephone | 816-508-3313
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Fax | 816-508-3321
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Provider Business Mailing Address
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Address Line | 3007 W 72ND TER
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-3161
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Country | US
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Telephone | 913-236-4680
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6190
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License Number State | KS
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