Basic Information
| Provider Information | |||||||||
| NPI: | 1093334286 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DRUM | ||||||||
| FirstName: | DAVID | ||||||||
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| Credential: | LAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33989 W 90TH CIR | ||||||||
| Address2: | |||||||||
| City: | DE SOTO | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660188601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132694477 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6331 W 110TH ST | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662111509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136961911 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2020 | ||||||||
| LastUpdateDate: | 04/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 1631 | KS | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.