Provider Demographics
NPI:1023386729
Name:GRANGER BORDEGON, PIPER (MSW)
Entity Type:Individual
Prefix:
First Name:PIPER
Middle Name:
Last Name:GRANGER BORDEGON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:PIPER
Other - Middle Name:
Other - Last Name:GRANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13013 GRANADA RD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2373
Mailing Address - Country:US
Mailing Address - Phone:937-901-0746
Mailing Address - Fax:
Practice Address - Street 1:13013 GRANADA RD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-2373
Practice Address - Country:US
Practice Address - Phone:937-901-0746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8299104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker