Healthcare Provider Details
I. General information
NPI: 1518002849
Provider Name (Legal Business Name): KELLY DAWN KUHN LCMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7272 K-4 HIGHWAY SUITE CC
MERIDEN KS
66512
US
IV. Provider business mailing address
7696 ANDERSON RD
MERIDEN KS
66512-9331
US
V. Phone/Fax
- Phone: 785-484-3441
- Fax: 785-484-3441
- Phone: 785-484-2056
- Fax: 785-484-2056
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 021 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: