Individual
MS. MYKAILA BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
210 SW MARKET ST STE 243, LEES SUMMIT, MO 64063-2314
(816) 710-2104
Mailing address
210 SW MARKET ST # 243, LEES SUMMIT, MO 64063-2314
(816) 710-2104
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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