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General NPI Number Information
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NPI Number | 1699253302
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Entity Type | Individual
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Provider Name | VICTORIA ANNETTE MCGRADY MS
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Gender | Female
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Dates
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Enumeration Date | 08/03/2018
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Last Update Date | 08/03/2018
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Provider Practice Location Address
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Address Line | 1845 FAIRMOUNT ST
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City | WICHITA
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State | KS
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Zip | 67260-9700
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Country | US
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Telephone | 316-978-6101
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Fax |
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Provider Business Mailing Address
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Address Line | 1845 FAIRMOUNT BOX 91
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City | WICHITA
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State | KS
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Zip | 67260-0091
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Country | US
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Telephone | 321-431-8878
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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