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General NPI Number Information
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NPI Number | 1598924060
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Entity Type | Organization
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Legal Business Name | INDIVIDUAL AND FAMILY SYSTEMS
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 2024 N WOODLAWN ST STE 409
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City | WICHITA
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State | KS
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Zip | 67208-1879
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Country | US
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Telephone | 316-689-8787
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Fax | 316-688-9897
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Provider Business Mailing Address
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Address Line | 2024 N WOODLAWN ST STE 409
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City | WICHITA
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State | KS
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Zip | 67208-1879
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Country | US
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Telephone | 316-689-8787
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Fax | 316-688-9897
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISS ELEANOR KAY SHIVE
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Credential | LCMFT
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Telephone | 316-689-8787
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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 |
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License Number State |
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