Individual
JOSHUA CHARLES ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-1000
Mailing address
8004 E 51ST ST, KANSAS CITY, MO 64129-2366
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2019031646
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490078915
—
MO
Enumeration date
11/14/2019
Last updated
12/22/2020
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