| Marla V. Clouse Corp | |
|
4122 E Lewis St Wichita KS 67218-1332 | |
| (316) 619-6805 | |
| Not Available |
| Full Name | Marla V. Clouse Corp |
|---|---|
| Speciality | Social Worker |
| Location | 4122 E Lewis St, Wichita, Kansas |
| Authorized Official Name and Position | Marla V Clouse (OWNER) |
| Authorized Official Contact | 3166196805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marla V. Clouse Corp 4122 E Lewis St Wichita KS 67218-1332 Ph: (316) 619-6805 | Marla V. Clouse Corp 4122 E Lewis St Wichita KS 67218-1332 Ph: (316) 619-6805 |
| NPI Number | 1265129548 |
|---|---|
| Provider Enumeration Date | 04/18/2023 |
| Last Update Date | 04/18/2023 |
| Certification Date | 04/18/2023 |
| Medicare PECOS PAC ID | 1153769906 |
|---|---|
| Medicare Enrollment ID | O20240329001802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265129548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Marla V Clouse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508263146 PECOS PAC ID: 4183983356 Enrollment ID: I20240329001932 |
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