| Teraspot, Llc | |
|
306 N Rock Rd Ste 30 Wichita KS 67206-2256 | |
| (316) 775-1415 | |
| Not Available |
| Full Name | Teraspot, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 306 N Rock Rd Ste 30, Wichita, Kansas |
| Authorized Official Name and Position | Germaine C Hall (OWNER, THERAPIST) |
| Authorized Official Contact | 3167751415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Teraspot, Llc 306 N Rock Rd Ste 30 Wichita KS 67206-2256 Ph: (316) 775-1415 | Teraspot, Llc 306 N Rock Rd Ste 30 Wichita KS 67206-2256 Ph: (316) 775-1415 |
| NPI Number | 1366059727 |
|---|---|
| Provider Enumeration Date | 09/29/2020 |
| Last Update Date | 04/25/2024 |
| Certification Date | 04/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366059727 | NPI | - | NPPES |
| 1447884143 | Other | INDIVIDUAL NPI | |
| 201288580A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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