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MR. JUSTIN MICHAEL THAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
4505 E 47TH ST S, WICHITA, KS 67210-1651
(316) 529-9130
(316) 529-9351
Mailing address
900 W BROADWAY ST, NEWTON, KS 67114-2037
(316) 283-1950
(316) 283-9540

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6010
KS

Other

Enumeration date
05/23/2007
Last updated
07/08/2007
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