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General NPI Number Information
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NPI Number | 1962660597
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Entity Type | Organization
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Legal Business Name | SUSAN DROE INC.
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 3438 ASHLAND AVE SUITE X
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-1333
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Country | US
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Telephone | 816-752-8196
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Fax | 816-364-2725
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Provider Business Mailing Address
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Address Line | 3438 ASHLAND AVE SUITE X
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-1333
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Country | US
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Telephone | 816-752-8196
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Fax | 816-364-2725
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MS. SUSAN J DROE-PUNZO
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Credential | MSW
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Telephone | 816-752-8196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 002105
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License Number State | MO
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