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General NPI Number Information
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NPI Number | 1811547979
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Entity Type | Individual
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Provider Name | TERESSA THURWANGER
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Gender | Female
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 4110 BALTIMORE AVE
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City | KANSAS CITY
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State | MO
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Zip | 64111-2303
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Country | US
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Telephone | 913-485-7674
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Fax |
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Provider Business Mailing Address
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Address Line | 11725 S SHANNAN ST APT 809
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City | OLATHE
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State | KS
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Zip | 66062-3753
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Country | US
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Telephone | 913-485-7674
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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