MEDICARE: MS. DEBRA POMROY STARR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	4636	KS
2	1041C0700X	Clinical Social Worker	2016005650	MO

General Provider Information

NPI Number	:	1417494923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA POMROY STARR

Provider Business Mailing Address
First Line	:	833 W 51ST ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-2372
Country	:	US
Telephone Number	:	816-519-3003
Fax Number	:	816-753-5755

Provider Business Practice Location Address
First Line	:	833 W 51ST ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-2372
Country	:	US
Telephone Number	:	816-519-3003
Fax Number	:	816-753-5755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2017
Last Update Date	:	03/05/2017

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