Healthcare Provider Details

I. General information

NPI: 1730817065
Provider Name (Legal Business Name): TAYLOR ANN DINKEL MS, LMLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2022
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16979 W 94TH ST
LENEXA KS
66219-1939
US

IV. Provider business mailing address

16979 W 94TH ST
LENEXA KS
66219-1939
US

V. Phone/Fax

Practice location:
  • Phone: 785-639-0532
  • Fax:
Mailing address:
  • Phone: 785-639-0532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number03369
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: