Individual
SANDRA SUE DEATLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2328 NE 37TH ST, KANSAS CITY, MO 64116-2503
(816) 531-4285
Mailing address
2328 NE 37TH ST, KANSAS CITY, MO 64116-2503
(816) 531-4285
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2019028335
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019028335
MISSOURI CLINICAL SOCIAL WORKER LICENSE
MO
Enumeration date
01/09/2021
Last updated
01/09/2021
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