Organization Name: | R B SHONKWILER LLC |
NPI Number: | 1194978247 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT B SHONKWILER (DIRECTOR OF COUNSELING SERVICES) |
Mailing Address: | 12735 Ewing Ave Grandview |
State: | MO US |
Postal Code: | 640302055 |
Phone Number: | 8163047793 |
Fax Number: | |
NPI Enumeration Date: | 11/01/2008 |
NPI Last Update Date: | 11/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 2007035389 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |