Individual
CONNIE FAYE SUDERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
1660 N TYLER RD, SUITE A, WICHITA, KS 67212-4917
(316) 722-4884
(316) 722-4893
Mailing address
1660 N TYLER RD, SUITE A, WICHITA, KS 67212-4917
(316) 722-4884
(316) 722-4893
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LMSW-2560
KS
1041C0700X
Clinical Social Worker
Primary
LSCSW - 4016
KS
Other
Enumeration date
12/06/2007
Last updated
11/22/2013
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