Individual
MS. KRISTIN ANNE COBLENTZ SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7001 BLUE RIDGE BLVD, RAYTOWN, MO 64133-5629
(816) 966-0900
(816) 347-3029
Mailing address
128 SE SOMERSET CT, LEES SUMMIT, MO 64063-3626
(816) 804-8847
(816) 581-3738
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
4902
KS
1041C0700X
Clinical Social Worker
Primary
2004032834
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498735109
—
MO
Enumeration date
03/08/2007
Last updated
12/06/2022
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