Provider Demographics
NPI:1407050222
Name:CURIEL, SHANDA L (PSYD)
Entity Type:Individual
Prefix:MS
First Name:SHANDA
Middle Name:L
Last Name:CURIEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E 24TH ST
Mailing Address - Street 2:UNIT 2-D
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2776
Mailing Address - Country:US
Mailing Address - Phone:816-404-3893
Mailing Address - Fax:816-404-3881
Practice Address - Street 1:1000 E 24TH ST
Practice Address - Street 2:UNIT 2-D
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2776
Practice Address - Country:US
Practice Address - Phone:816-404-3893
Practice Address - Fax:816-404-3881
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-LP 1784103TC0700X
MO2007029985103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical