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General NPI Number Information
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NPI Number | 1104963222
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Entity Type | Individual
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Provider Name | TERESA MARIE COWAN-CHRISTEN PSY.D, M.A.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/04/2013
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Provider Practice Location Address
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Address Line | 10333 E 21ST ST N SUITE 204
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City | WICHITA
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State | KS
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Zip | 67206-3543
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Country | US
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Telephone | 316-630-8444
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Fax | 316-630-8449
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Provider Business Mailing Address
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Address Line | 1335 N ROBIN CT
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City | ANDOVER
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State | KS
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Zip | 67002-7402
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Country | US
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Telephone | 316-213-3788
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | T-LP 2080
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License Number State | KS
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