| NPI | 1083908610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE L. WASHINGTON Lcpc 913-669-8251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: KS 708) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2011-05-31 |