Organization
WICHITA STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON DOUGLAS BEYER MA (PSYCHOLOGY INTERN)
(502) 821-7904
Entity
Organization
Contact information
Practice address
1845 FAIRMOUNT BOX 91, WICHITA, KS 67260-0091
(502) 821-7904
Mailing address
1845 FAIRMOUNT BOX 91, WICHITA, KS 67260-0091
(502) 821-7904
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0914
KY
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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