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General NPI Number Information
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NPI Number | 1275678146
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Entity Type | Individual
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Provider Name | KELLY RENEE WALKER LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1660 N TYLER RD SUITE A
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City | WICHITA
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State | KS
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Zip | 67212-1505
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Country | US
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Telephone | 316-648-9572
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Fax | 316-773-5430
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Provider Business Mailing Address
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Address Line | 1660 N TYLER RD SUITE A
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City | WICHITA
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State | KS
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Zip | 67212-1505
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Country | US
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Telephone | 316-648-9572
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Fax | 316-773-5430
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 646
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License Number State | KS
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