Individual
SHIRLEY JEAN COCHRAN-SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7840 WASHINGTON AVE, KANSAS CITY, KS 66112-2152
(913) 328-4600
Mailing address
1301 N 47TH ST, KANSAS CITY, KS 66102-1705
(913) 233-3300
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3127
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098080A
—
KS
01
—
100098080C
SED WAIVER
KS
01
—
3620000
MEDICARE
KS
Enumeration date
09/12/2017
Last updated
09/12/2017
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