Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 1735 | KS |
NPI | 1033373345 |
---|---|
Provider Name | Nicole M Klaus |
First Address | Wichita, KS 67214-3199 |
Second Address | Wichita, KS 67214-3199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 16/07/2008 |