JESSICA LYNN PROVINES

WICHITA, KS
NPI1710083183
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist Clinical
(Licence: KS  997)
Enumeration Date2006-09-15
Last Update Date2007-07-08
Business Address
JESSICA LYNN PROVINES TLMLP
7570 W 21ST ST N
WICHITA, KS 67205-1734
Phone number: 316-729-6555
Mailing Address
JESSICA LYNN PROVINES TLMLP
1545 N HOOD ST
WICHITA, KS 67203-2846
Phone number: 316-655-9964
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