Individual
JILL ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMLP
Contact information
Practice address
217 W IRA CT, ANDOVER, KS 67002-9469
(316) 733-5047
Mailing address
520 E AUGUSTA AVE, AUGUSTA, KS 67010-2100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2900
KS
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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