Organization
BJM FAIRY GODMOTHER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA JEAN MARVIN LCSW (PRESIDENT)
(913) 220-2435
Entity
Organization
Contact information
Practice address
6170 SNI A BAR RD, KANSAS CITY, MO 64129-1955
(913) 220-2435
(913) 220-2435
Mailing address
6170 SNI A BAR RD, KANSAS CITY, MO 64129-1955
(913) 220-2435
(913) 220-2435
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/05/2009
Last updated
02/05/2009
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