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NPI Code Detail

MEDICARE: TEFFANY ROBERTS

MEDICARE: TEFFANY ROBERTS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor01833KS

General Provider Information

NPI Number : 1023792553
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEFFANY ROBERTS
Provider Business Mailing Address
First Line : 130 E 5TH ST
Second Line :
City : NEWTON
State : KS
Zip : 67114-2206
Country : US
Telephone Number : 316-283-6743
Fax Number : 620-322-0272
Provider Business Practice Location Address
First Line : 3820 N TOBEN ST
Second Line :
City : WICHITA
State : KS
Zip : 67226-2903
Country : US
Telephone Number : 316-634-3954
Fax Number : 316-634-3956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2023
Last Update Date : 06/14/2023

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Directions to “ TEFFANY ROBERTS ” Practice Location

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