MEDICARE: JENNIFER RANAE HARMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	341	KS

General Provider Information

NPI Number	:	1376628719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER RANAE HARMS

Provider Business Mailing Address
First Line	:	433 S GLENDALE ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67218-1536
Country	:	US
Telephone Number	:	316-371-6914
Fax Number	:

Provider Business Practice Location Address
First Line	:	5745 E CENTRAL AVE
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67208-4202
Country	:	US
Telephone Number	:	316-315-2121
Fax Number	:	316-315-2122

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	04/18/2024

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