Organization
WICHITA GROWTH CENTER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD THOMAS BLASI PH.D. (DIRECTOR)
(316) 684-2422
Entity
Organization
Contact information
Practice address
641 S HILLSIDE ST, WICHITA, KS 67211-3001
(316) 684-2422
(316) 684-1210
Mailing address
641 S HILLSIDE ST, WICHITA, KS 67211-3001
(316) 684-2422
(316) 684-1210
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0252
KS
Other
Enumeration date
01/05/2007
Last updated
08/22/2020
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