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Organization
REAL LIFE LLC
Active
Organization
REAL LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICE HINECKER (OFFICE MANAGER)
(316) 425-7774
Entity
Organization
Contact information
Practice address
8911 E ORME ST STE D, WICHITA, KS 67207-2424
(316) 425-7774
Mailing address
8911 E ORME ST STE D, WICHITA, KS 67207-2424
(316) 425-7774
(316) 425-7779
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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