Individual
CHRISTA GOSNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
5535 S DODGE ST, WICHITA, KS 67217-6403
(316) 712-0903
(855) 871-5714
Mailing address
5535 S DODGE ST, WICHITA, KS 67217-6403
(316) 712-0903
(855) 871-5714
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11193
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201216140A
—
KS
Enumeration date
10/01/2018
Last updated
11/03/2021
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