| NPI | 1770842114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY M. JACOBS Licensed Clinical Psychotherapist 316-636-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KS 188) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |