Individual
TINA WILMA SANBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSMFT
Contact information
Practice address
1170 W. KANSAS ST., LIBERTY, MO 64068
(816) 351-7834
Mailing address
1806 MANSFIELD RD, SAINT JOSEPH, MO 64504
(816) 351-7834
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2011012317
MO
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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