| NPI | 1053678904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK PRICHARD Excutive Director 316-869-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 2001) |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2012-04-17 |