Organization
FOUR BRANCHES THERAPY & WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY D STUEVER LCMFT (OWNER/THERAPIST)
(316) 648-8886
Entity
Organization
Contact information
Practice address
11828 W CENTRAL AVE STE 104, WICHITA, KS 67212-5178
(316) 648-8886
Mailing address
11828 W CENTRAL AVE STE 104, WICHITA, KS 67212-5178
(316) 648-8886
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCMFT 756
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200671720B
—
KS
Enumeration date
01/04/2012
Last updated
11/12/2021
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