Provider Demographics
NPI:1356511380
Name:SCHLICK, SALLY (RD)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:SCHLICK
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E RED BRIDGE RD
Mailing Address - Street 2:STE 304
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4035
Mailing Address - Country:US
Mailing Address - Phone:816-942-1811
Mailing Address - Fax:816-941-0419
Practice Address - Street 1:400 E RED BRIDGE RD
Practice Address - Street 2:STE 304
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-4035
Practice Address - Country:US
Practice Address - Phone:816-942-1811
Practice Address - Fax:816-941-0419
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered