Individual
MELISSA SHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
11120 W 65TH ST, SHAWNEE, KS 66203-5504
(913) 826-4200
Mailing address
6000 LAMAR AVE STE 130, MISSION, KS 66202-3234
(913) 826-4200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
105
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100106710 I
—
KS
Enumeration date
06/18/2014
Last updated
03/19/2024
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