Healthcare Provider Details

I. General information

NPI: 1902237530
Provider Name (Legal Business Name): CHRISTINE MUTHONI KITHINJI P.HD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2013
Last Update Date: 12/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 KS HIGHWAY 264
LARNED KS
67550-5353
US

IV. Provider business mailing address

303 HILLCREST DR
LARNED KS
67550-4001
US

V. Phone/Fax

Practice location:
  • Phone: 620-285-4836
  • Fax: 620-285-4509
Mailing address:
  • Phone: 608-514-8954
  • Fax: 620-285-4509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberT-LP 2187
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: