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General NPI Number Information
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NPI Number | 1407223878
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Entity Type | Organization
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Legal Business Name | CAITLYN SROUR
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 10333 E 21ST ST N STE 204
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City | WICHITA
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State | KS
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Zip | 67206-3543
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Country | US
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Telephone | 316-630-8444
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Fax |
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Provider Business Mailing Address
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Address Line | 10333 E 21ST ST N STE 204
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City | WICHITA
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State | KS
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Zip | 67206-3543
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Country | US
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Telephone | 316-630-8444
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | CAITLYN SROUR
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Credential |
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Telephone | 316-706-8686
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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 | 2696
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License Number State | KS
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