| NPI | 1720596240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA O'BRIEN Psychotherapist 316-282-4985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 4750) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R076120-1) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2019-02-27 |