Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 219 | KS |
N | 101YP2500X | Professional Counselor | 961 | KS |
Y | 104100000X | Social Worker | 7733 | KS |
NPI | 1003112889 |
---|---|
Provider Name | Ms. Vivica Yvonne Snype-Stewart |
First Address | Kansas City, MO 64108-1530 |
Second Address | Kansas City, MO 64108-1530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2011 |
Last Update Date | 26/10/2012 |