| NPI | 1053522441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP DOUGLAS HENDERSON Office Manager 785-539-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 74864) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2020-08-22 |