Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 2018013688 | MO |
NPI | 1003373044 |
---|---|
Provider Name | Dhruti Umang Shah |
First Address | Kansas City, MO 64109-2073 |
Second Address | Kansas City, MO 64109-2073 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2019 |
Last Update Date | 26/02/2019 |