Provider Demographics
NPI:1699549634
Name:MCCORD, ISABELLA P
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:P
Last Name:MCCORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 COLLEGE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2671
Mailing Address - Country:US
Mailing Address - Phone:913-820-2106
Mailing Address - Fax:913-815-4127
Practice Address - Street 1:8101 COLLEGE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2671
Practice Address - Country:US
Practice Address - Phone:913-820-2106
Practice Address - Fax:913-815-4127
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician