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General NPI Number Information
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NPI Number | 1427692979
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Entity Type | Individual
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Provider Name | HAREG TILAHUN ESHETE
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Gender | Female
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 4801 E LINWOOD BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64128-2226
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Country | US
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Telephone | 816-461-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 8719 NOLAND RD
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City | LENEXA
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State | KS
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Zip | 66215-3433
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Country | US
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Telephone | 913-636-9642
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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 | 10941
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2019035029
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License Number State | MO
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