Individual
GLENN J VEENSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
7829 E ROCKHILL ST, SUITE #105, WICHITA, KS 67206-3920
(316) 293-3850
(316) 683-6733
Mailing address
1010 N KANSAS, SUITE #3049, WICHITA, KS 67214-3199
(316) 293-2647
(316) 293-1882
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0507
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04414
BCBS
KS
05
—
100237810A
—
KS
Enumeration date
04/06/2006
Last updated
11/25/2009
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