Individual
MRS. DANA SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
14884 E SUNDANCE ST, WICHITA, KS 67230-7162
(316) 841-9567
Mailing address
14884 E SUNDANCE ST, WICHITA, KS 67230-7162
(316) 841-9567
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3972
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3972
KANSAS DEPARTMENT OF HEALTH OCCUPATIONS CREDENTIALING NUMBER
KS
Enumeration date
07/30/2021
Last updated
07/30/2021
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