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NPI Code Detail

MEDICARE: DR. CHRISTINA LEIGH MARVIN PHD

MEDICARE: DR. CHRISTINA LEIGH MARVIN PHD
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
1103TC0700XClinical Psychologist2165KS

General Provider Information

NPI Number : 1386902237
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINA LEIGH MARVIN PHD
Provider Business Mailing Address
First Line : 2903 N. CYPRESS
Second Line :
City : WICHITA
State : KS
Zip : 67226
Country : US
Telephone Number : 316-204-0741
Fax Number :
Provider Business Practice Location Address
First Line : 2903 N. CYPRESS
Second Line :
City : WICHITA
State : KS
Zip : 67226-5010
Country : US
Telephone Number : 316-204-0741
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2012
Last Update Date : 08/08/2022

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