Individual
MRS. ILENE FAY SCHALLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSW LCSW
Contact information
Practice address
4208 KENSINGTON DR, SAINT JOSEPH, MO 64506-4550
(816) 233-9998
(816) 279-9666
Mailing address
4208 KENSINGTON DR, SAINT JOSEPH, MO 64506-4550
(816) 233-9998
(816) 279-9666
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
002698
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35978015
BLUE CROSS/BLUE SHIELD
MO
Enumeration date
09/13/2005
Last updated
07/08/2007
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