Individual
AUTUMN TAYA POURHUSSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMLP-T
Contact information
Practice address
8100 E 22ND ST N STE 100, WICHITA, KS 67226-2350
(316) 201-6047
Mailing address
1837 DROLLINGER ST, WICHITA, KS 67218-4705
(316) 393-8792
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
03337-T
KS
103TC1900X
Counseling Psychologist
Primary
03386
KS
Other
Enumeration date
01/07/2025
Last updated
03/07/2025
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