Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 9174 | KS |
NPI | 1003225574 |
---|---|
Provider Name | Mrs. Stephanie Shanelec-Keeler |
First Address | Wichita, KS 67203-3602 |
Second Address | Wichita, KS 67208-4000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2014 |
Last Update Date | 08/08/2014 |