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General NPI Number Information
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NPI Number | 1689807059
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Entity Type | Organization
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Legal Business Name | SERENITY THERAPY SERVICES LLC
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 4031 E HARRY ST
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City | WICHITA
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State | KS
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Zip | 67218-3724
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Country | US
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Telephone | 316-771-7570
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Fax | 316-771-7201
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Provider Business Mailing Address
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Address Line | 4031 E HARRY ST
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City | WICHITA
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State | KS
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Zip | 67218-3724
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Country | US
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Telephone | 316-771-7570
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Fax | 316-771-7201
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Authorized Official
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Title or Position | MARRIAGE & FAMILY THERAPIST/OWNER
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Name | MS. CHI-CHI EMEANA
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Credential | LMFT
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Telephone | 316-807-5709
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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 | 1001
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License Number State | KS
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