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General NPI Number Information
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NPI Number | 1376408690
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Entity Type | Individual
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Provider Name | THOMASA SHANNEL KING
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Gender | Female
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 2705 E 24TH ST # AT
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City | KANSAS CITY
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State | MO
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Zip | 64127-4016
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Country | US
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Telephone | 816-302-5622
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Fax |
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Provider Business Mailing Address
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Address Line | 2705 E 24TH ST # AT
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City | KANSAS CITY
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State | MO
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Zip | 64127-4016
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Country | US
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Telephone | 816-302-5622
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT25-453608
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License Number State | MO
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