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Individual

MS. FAYE CLARE MAHER JURADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.C. & L.M.A.C

Contact information

Practice address
6331 W 110TH ST, OVERLAND PARK, KS 66211-1509
(913) 696-1911
(913) 696-1619
Mailing address
12311 W 79TH TER, LENEXA, KS 66215-2603
(913) 203-8939

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
697
KS
101YP2500X
Professional Counselor
Primary
2139
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101YA0400X
KS
Enumeration date
09/28/2009
Last updated
01/06/2020
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