Individual
MRS. LATUNDRA R BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14013 GARNETT ST, OVERLAND PARK, KS 66221-2807
(816) 356-4615
Mailing address
1415 NE AMANDA JEAN WAY, GRAIN VALLEY, MO 64029-7838
(816) 820-6141
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
10063429
MO
Other
Enumeration date
09/27/2007
Last updated
07/18/2012
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