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General NPI Number Information
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NPI Number | 1598732273
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Entity Type | Individual
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Provider Name | GEORGE M WINE CHASE M.DIV., M.S.
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Gender | Male
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Dates
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Enumeration Date | 03/02/2006
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 9233 WARD PKWY SUITE 305
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City | KANSAS CITY
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State | MO
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Zip | 64114-3366
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Country | US
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Telephone | 816-824-9898
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Fax | 816-527-8052
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Provider Business Mailing Address
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Address Line | 9233 WARD PKWY SUITE 305
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City | KANSAS CITY
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State | MO
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Zip | 64114-3366
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Country | US
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Telephone | 816-824-9898
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Fax | 816-527-8052
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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 | 2669
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License Number State | MO
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