| NPI | 1306738562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA TILTON Credentialing 316-691-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-07-21 |