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General NPI Number Information
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NPI Number | 1215154307
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Entity Type | Individual
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Provider Name | JOLENA KAY MAULDIN LCP
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 801 N MUR LEN RD SUITE 101
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City | OLATHE
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State | KS
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Zip | 66062-1794
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Country | US
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Telephone | 713-710-9382
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Fax | 610-643-8266
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Provider Business Mailing Address
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Address Line | 801 N MUR LEN RD STE 101
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City | OLATHE
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State | KS
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Zip | 66062-1794
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Country | US
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Telephone | 913-710-9382
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Fax | 610-643-8266
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 195
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License Number State | KS
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