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General NPI Number Information
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NPI Number | 1922459221
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Entity Type | Individual
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Provider Name | LEEWA KHATIWADA LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 500 MEDICAL DR
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City | WENTZVILLE
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State | MO
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Zip | 63385-3421
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Country | US
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Telephone | 636-327-1355
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Fax | 636-327-1352
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Provider Business Mailing Address
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Address Line | WARD # 13 KUSUNTI
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City | KATHMANDU
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State | LALITPUR
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Zip | 0000
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Country | NP
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Telephone |
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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 | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 2014025364
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License Number State | MO
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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 | 2014025364
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License Number State | MO
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