Individual
OLIVIA NANGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14801 E HAWTHORNE ST, WICHITA, KS 67230-9658
(316) 206-3907
Mailing address
14801 E HAWTHORNE ST, WICHITA, KS 67230-9658
(316) 206-3907
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P8B384W06762
BCBS
KS
Enumeration date
01/30/2023
Last updated
01/30/2023
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