| NPI | 1922403476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW L. PENNER Therapist/Owner 620-200-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 4227) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |