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General NPI Number Information
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NPI Number | 1295936151
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Entity Type | Organization
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Legal Business Name | ANGELA N. HOLOUBEK, LSCSW
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 313 N SENECA ST #117
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City | WICHITA
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State | KS
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Zip | 67203-5937
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Country | US
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Telephone | 316-804-5135
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Fax | 888-393-8364
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Provider Business Mailing Address
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Address Line | 313 N SENECA ST #117
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City | WICHITA
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State | KS
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Zip | 67203-5937
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Country | US
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Telephone | 316-804-5135
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Fax | 888-393-8364
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Authorized Official
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Title or Position | OWNER
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Name | MS. ANGELA NICHOLE HOLOUBEK
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Credential | LSCSW
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Telephone | 316-804-5135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2485
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License Number State | KS
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