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General NPI Number Information
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NPI Number | 1760244933
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Entity Type | Individual
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Provider Name | BRANDI ANDERSON LMLP-T
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Gender | Female
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 6606 W CENTRAL AVE
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City | WICHITA
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State | KS
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Zip | 67212-3315
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Country | US
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Telephone | 316-221-2661
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Fax |
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Provider Business Mailing Address
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Address Line | 1624 N ROBIN CIR
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City | WICHITA
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State | KS
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Zip | 67212-5836
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Country | US
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Telephone | 316-371-4222
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 03281-T
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License Number State | KS
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