# REAL LIFE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265901722
- **Authorized official:** PATRICE HINECKER (OFFICE MANAGER)
- **Authorized official phone:** (316) 425-7774

## Contact information

- **Practice address:** 8911 E ORME ST STE D, WICHITA, KS 67207-2424
- **Practice address phone:** (316) 425-7774
- **Mailing address:** 8911 E ORME ST STE D, WICHITA, KS 67207-2424
- **Mailing address phone:** (316) 425-7774
- **Mailing address fax:** (316) 425-7779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |

## Other

- **Enumeration date:** 11/14/2018
- **Last updated:** 11/14/2018