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Individual

ERICA THOMAS IMMENSCHUH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSCSW

Contact information

Practice address
6440 NIEMAN RD, SHAWNEE, KS 66203-3326
(913) 962-9955
Mailing address
6000 LAMAR AVE, STE 130, MISSION, KS 66202-3234
(913) 831-2550
(913) 826-1589

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2047
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100098010
KS
01
26787012
BCBS OF KC
Enumeration date
08/30/2006
Last updated
07/23/2010
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