Individual
EDIE DIANE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1301 N 47TH ST, KANSAS CITY, KS 66102-1705
(913) 288-4252
Mailing address
1301 N 47TH ST, KANSAS CITY, KS 66102-1705
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10567
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098080A
—
KS
01
—
100098080C
SED WAIVER
KS
Enumeration date
08/22/2017
Last updated
08/22/2017
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