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General NPI Number Information
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NPI Number | 1518659077
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Entity Type | Individual
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Provider Name | MALACHI GABRIEL WINTERS LMSW
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Gender | Male
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 2552 N FOX RUN CT
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City | WICHITA
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State | KS
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Zip | 67226-3607
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Country | US
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Telephone | 316-640-8681
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Fax |
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Provider Business Mailing Address
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Address Line | 2552 N FOX RUN CT
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City | WICHITA
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State | KS
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Zip | 67226-3607
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Country | US
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Telephone | 316-640-8681
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 13091
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License Number State | KS
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