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General NPI Number Information
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NPI Number | 1710259098
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Entity Type | Individual
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Provider Name | JENNIFER A PREWITT PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 650 HUEBNER RD DBH, 4TH FLOOR, ROOM 4A130
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City | FORT RILEY
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State | KS
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Zip | 66442-4030
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Country | US
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Telephone | 785-239-7874
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Fax | 785-240-8358
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Provider Business Mailing Address
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Address Line | 650 HUEBNER RD DBH, 4TH FLOOR, ROOM 4A130
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City | FORT RILEY
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State | KS
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Zip | 66442-4030
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Country | US
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Telephone | 785-239-7874
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Fax | 785-240-8358
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 3166
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 2534
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2534
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License Number State | KS
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