Organization
DR. MELINDA SHAVER, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELINDA ANNE SHAVER PSYD (LICENSED PSYCHOLOGIST)
(620) 926-1286
Entity
Organization
Contact information
Practice address
201 N PENN AVE, SUITE 507, INDEPENDENCE, KS 67301-3357
(620) 926-1286
Mailing address
201 N PENN AVE, SUITE 507, INDEPENDENCE, KS 67301-3357
(620) 926-1286
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2326
KS
251S00000X
Community/Behavioral Health Agency
962
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201124310A
—
KS
Enumeration date
08/10/2015
Last updated
03/02/2016
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