Bjm Fairy Godmother LLC

NPI #1205075801 in Kansas City, Missouri

Provider Information

NPI Number: 1205075801
Entity Type: Organization
Organization Name: Bjm Fairy Godmother LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Feb 5, 2009
Last Updated: Feb 5, 2009

Practice Location

Address: 6170 SNI A BAR RD
City: Kansas City
State: Missouri
ZIP Code: 64129-1955
Phone: (913) 220-2435

Authorized Official

Name: BARBARA JEAN MARVIN, LCSW
Title: PRESIDENT
Phone: (913) 220-2435

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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