MEDICARE: MR. ALFREDO MUNOZ ED.S

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	101YM0800X	Mental Health Counselor	015	KS

General Provider Information

NPI Number	:	1750408175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALFREDO MUNOZ ED.S

Provider Business Mailing Address
First Line	:	5600 WEST 92ND TERRACE
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66207
Country	:	US
Telephone Number	:	816-668-3967
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 W 75TH ST
Second Line	:
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-3503
Country	:	US
Telephone Number	:	816-668-3967
Fax Number	:

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	11/09/2011

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