Basic Information
| Provider Information | |||||||||
| NPI: | 1972884690 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOURNIER | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12320 FAIRWAY RD | ||||||||
| Address2: | |||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662092401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136961938 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9250 GLENWOOD ST | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662121365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9139526696 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2011 | ||||||||
| LastUpdateDate: | 09/08/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 8226 | KS | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.