Lieske, Jessica Miranda

Lieske, Jessica Miranda is an individual health care provider with primary practice located at 7840 Washington Ave , Kansas City KS 66112-2152. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Lieske, Jessica Miranda can be contacted via phone (913) 328-4600.

Contact Information

Primary practice address
7840 Washington Ave Kansas City KS 66112-2152
Phone: (913) 328-4600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1193 Kansas

Profile Details

NPI number 1639334410
LBN Legal business name Lieske, Jessica Miranda
Credentials TLMLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2008
Last updated Jul 22nd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639334410 NPPES
Kansas Other 100098080C SED WAIVER
Kansas MEDICAID 100098080A SED WAIVER

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