| NPI | 1285405522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RAE JOHNSON Credentialing Director 785-320-6616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TP0016X Psychologist Prescribing (Medical) | |
| 103TP0814X Psychologist Psychoanalysis | |
| 101YP2500X Counselor Professional | |
| 103G00000X Clinical Neuropsychologist | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 202D00000X | |
| 207QA0505X Family Medicine Adult Medicine | |
| 2084P0015X Psychiatry & Neurology Psychosomatic Medicine | |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-11-21 |