| Four Branches Therapy & Wellness, Llc | |
|
11828 W Central Ave Ste 104 Wichita KS 67212-5178 | |
| (316) 648-8886 | |
| Not Available |
| Full Name | Four Branches Therapy & Wellness, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11828 W Central Ave Ste 104, Wichita, Kansas |
| Authorized Official Name and Position | Tracy D Stuever (OWNER/THERAPIST) |
| Authorized Official Contact | 3166488886 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Branches Therapy & Wellness, Llc 11828 W Central Ave Ste 104 Wichita KS 67212-5178 Ph: (316) 648-8886 | Four Branches Therapy & Wellness, Llc 11828 W Central Ave Ste 104 Wichita KS 67212-5178 Ph: (316) 648-8886 |
| NPI Number | 1114297314 |
|---|---|
| Provider Enumeration Date | 01/04/2012 |
| Last Update Date | 11/12/2021 |
| Certification Date | 11/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114297314 | NPI | - | NPPES |
| 200671720B | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LCMFT 756 (Kansas) | Primary |
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