Individual
MRS. KEENA DEANE CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC-TS
Contact information
Practice address
939 N MAIN ST, WICHITA, KS 67203-3608
(316) 263-8807
Mailing address
2620 E 21ST ST N, WICHITA, KS 67214-2248
(316) 214-1967
(316) 660-6662
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
KS
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
08/07/2018
Last updated
04/29/2025
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