=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649381567
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIM KAY HANDER LCMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5655 SW 34TH PL
-----------------------------------------------------
City | TOPEKA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66614-4581
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-271-6559
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2055 SW CLAY ST
-----------------------------------------------------
City | TOPEKA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66604-3078
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-234-5663
-----------------------------------------------------
Fax | 785-232-6811
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | LCMFT 245
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------