| Fostering Ambition To Initiate Therapeutic Healing Therapy Group | |
|
30 W Pershing Rd Unit 413709 Kansas City MO 64141-7610 | |
| (816) 944-0858 | |
| Not Available |
| Full Name | Fostering Ambition To Initiate Therapeutic Healing Therapy Group |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 30 W Pershing Rd Unit 413709, Kansas City, Missouri |
| Authorized Official Name and Position | Leshaunda Rockett-dixon (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8169440858 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fostering Ambition To Initiate Therapeutic Healing Therapy Group 30 W Pershing Rd Unit 413709 Kansas City MO 64141-7610 Ph: (816) 944-0858 | Fostering Ambition To Initiate Therapeutic Healing Therapy Group 30 W Pershing Rd Unit 413709 Kansas City MO 64141-7610 Ph: (816) 944-0858 |
| NPI Number | 1619644630 |
|---|---|
| Provider Enumeration Date | 08/26/2021 |
| Last Update Date | 08/26/2021 |
| Certification Date | 08/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619644630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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