MEDICARE: MS. ANGELA J KAESTNER

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	103K00000X	Behavior Analyst
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1750629283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA J KAESTNER

Provider Business Mailing Address
First Line	:	11627 W 79TH ST
Second Line	:
City	:	LENEXA
State	:	KS
Zip	:	66214-1488
Country	:	US
Telephone Number	:	913-341-7077
Fax Number	:	785-865-5695

Provider Business Practice Location Address
First Line	:	821 ADMIRAL BLVD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64106-1516
Country	:	US
Telephone Number	:	816-889-3469
Fax Number	:

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

Provider Enumeration Date	:	01/17/2013
Last Update Date	:	12/11/2018

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