Organization
EVOLUTION WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLIVIA TICKLES (OWNER)
(316) 519-6063
Entity
Organization
Contact information
Practice address
2701 S VASSAR CT, WICHITA, KS 67210-1155
(316) 512-1658
Mailing address
2500 N ROOSEVELT ST, WICHITA, KS 67220-2815
(316) 512-1658
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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