| NPI | 1073097820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEENAN POORE Owner/Administrator/Provider 316-282-3444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |