Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 697 | KS |
Y | 101YP2500X | Professional Counselor | 2139 | KS |
NPI | 1003140781 |
---|---|
Provider Name | Ms. Faye Clare Maher Jurado |
First Address | Lenexa, KS 66215-2603 |
Second Address | Overland Park, KS 66211-1509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2009 |
Last Update Date | 06/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101YA0400X | (05) | KS |