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Individual

RAYMOND PENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSCSW

Contact information

Practice address
2700 E 30TH AVE, HUTCHINSON, KS 67502
(620) 663-8484
Mailing address
2700 E 30TH AVE, HUTCHINSON, KS 67502
(620) 663-8484

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7410
KS
1041C0700X
Clinical Social Worker
05301
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200264950A
KS
05
200627420B
KS
Enumeration date
06/05/2009
Last updated
06/09/2021
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