Individual
MISS SOPHIA MARILYN CHAMBERLAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10635 FLOYD ST, OVERLAND PARK, KS 66212-2548
(816) 337-2799
Mailing address
PO BOX 11971, KANSAS CITY, MO 64138-0971
(816) 337-2799
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
856142906
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
856178603
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
856243308
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
856348404
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043337942
—
MO
05
—
1164601563
—
MO
05
—
1396862298
—
MO
05
—
1609992635
—
MO
Enumeration date
05/25/2011
Last updated
05/25/2011
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