Individual
SUSAN W. DOCKING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13012 W 118TH TER, OVERLAND PARK, KS 66210-3513
(913) 469-0250
Mailing address
13012 W 118TH TER, OVERLAND PARK, KS 66210-3513
(913) 469-0250
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100392760 A
HCBS PROVIDER
KS
Enumeration date
05/20/2008
Last updated
05/20/2008
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