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General NPI Number Information
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NPI Number | 1356685283
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Entity Type | Individual
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Provider Name | DARWIN L EADS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 12/07/2012
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Provider Practice Location Address
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Address Line | 1508 N RIDGEHURST ST
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City | WICHITA
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State | KS
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Zip | 67230-7259
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Country | US
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Telephone | 316-927-2996
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 E KELLOGG DR 589A7-BH
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City | WICHITA
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State | KS
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Zip | 67218-1607
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Country | US
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Telephone | 316-651-3621
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 02809
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License Number State | MD
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