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General NPI Number Information
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NPI Number | 1043639354
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Entity Type | Individual
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Provider Name | VICKI GERSTNER LMSW
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Gender | Female
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 416 S MAIN ST SUITES 2 & 3
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City | OTTAWA
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State | KS
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Zip | 66067-2334
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Country | US
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Telephone | 785-242-8965
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Fax | 785-242-6947
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Provider Business Mailing Address
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Address Line | 21350 W 153RD ST
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City | OLATHE
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State | KS
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Zip | 66061-5413
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Country | US
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Telephone | 913-322-4900
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Fax | 913-780-1284
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LMSW 8313
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License Number State | KS
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