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General NPI Number Information
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NPI Number | 1316839061
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Entity Type | Organization
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Legal Business Name | LEATANYA E KOPPA, LLC
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 6606 W CENTRAL AVE
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City | WICHITA
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State | KS
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Zip | 67212-3315
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Country | US
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Telephone | 316-221-2661
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Fax | 316-636-1190
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Provider Business Mailing Address
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Address Line | 6606 W CENTRAL AVE
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City | WICHITA
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State | KS
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Zip | 67212-3315
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Country | US
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Telephone | 316-221-2661
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Fax | 316-636-1190
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NANCY PATTERSON
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Credential |
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Telephone | 316-636-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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