| Audrey L. Martin Llc | |
|
303 N West St Ste 220 Wichita KS 67203-1269 | |
| (316) 302-4988 | |
| Not Available |
| Full Name | Audrey L. Martin Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 303 N West St Ste 220, Wichita, Kansas |
| Authorized Official Name and Position | Audrey Martin (OWNER) |
| Authorized Official Contact | 3166442944 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Audrey L. Martin Llc 23527 Sycamore Heights Rd Siloam Springs AR 72761-8215 Ph: (316) 644-2944 | Audrey L. Martin Llc 303 N West St Ste 220 Wichita KS 67203-1269 Ph: (316) 302-4988 |
| NPI Number | 1750973053 |
|---|---|
| Provider Enumeration Date | 02/08/2021 |
| Last Update Date | 09/16/2024 |
| Certification Date | 09/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750973053 | NPI | - | NPPES |
| 200656430B | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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