Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 8463 | KS |
NPI | 1003207119 |
---|---|
Provider Name | Ms. Emily H Perlstein |
First Address | Kansas City, KS 66112-2152 |
Second Address | Kansas City, KS 66112-2152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2015 |
Last Update Date | 11/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100098080A | (05) | KS |
100098080C | SED WAIVER (01) | KS |
3620000 | MEDICARE (01) | KS |