Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 2019030585 | MO |
NPI | 1003454141 |
---|---|
Provider Name | James Matthew Fey |
First Address | Kansas City, MO 64137-2149 |
Second Address | Kansas City, MO 64119-4460 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2019 |
Last Update Date | 19/12/2019 |