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General NPI Number Information
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NPI Number | 1689548406
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Entity Type | Organization
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Legal Business Name | BRAIN AND BODY PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 800 E 1ST ST STE 240
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City | WICHITA
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State | KS
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Zip | 67202-2740
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Country | US
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Telephone | 316-260-6889
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Fax |
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Provider Business Mailing Address
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Address Line | 800 E 1ST ST STE 240
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City | WICHITA
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State | KS
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Zip | 67202-2740
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Country | US
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Telephone |
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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 | KRISTIN ROSE
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Credential | LCMFT
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Telephone | 316-285-0268
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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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