Individual
CHARITY ANN MUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAC/LPC
Contact information
Practice address
1916 16TH ST, GREAT BEND, KS 67530-4001
(620) 792-5405
Mailing address
1842 CR 370 RD, ALBERT, KS 67511
(620) 617-5497
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
388
KS
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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