Individual
MR. ROBERT RUSSELL TAVERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMFT
Contact information
Practice address
787 AVENUE N, CHASE, KS 67524-9462
(620) 938-9949
Mailing address
787 AVENUE N, CHASE, KS 67524-9462
(620) 938-9949
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
134
KS
Other
Enumeration date
02/28/2008
Last updated
02/28/2008
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