| P.a.t.h. Clinic, Llc | |
|
9342 E Central Ave Ste D Wichita KS 67206-2555 | |
| (316) 269-5000 | |
| (316) 269-0404 |
| Full Name | P.a.t.h. Clinic, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 9342 E Central Ave Ste D, Wichita, Kansas |
| Authorized Official Name and Position | Georgia Denne (MANAGER) |
| Authorized Official Contact | 3162695000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| P.a.t.h. Clinic, Llc 9342 E Central Ave Ste D Wichita KS 67206-2555 Ph: (316) 269-5000 | P.a.t.h. Clinic, Llc 9342 E Central Ave Ste D Wichita KS 67206-2555 Ph: (316) 269-5000 |
| NPI Number | 1962562496 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962562496 | NPI | - | NPPES |
| 066958 | Other | KS | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0718 (Kansas) | Primary |
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