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Individual

AUTUMN BOSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
4155 E HARRY ST, WICHITA, KS 67218-3725
(316) 665-2601
(316) 831-9569
Mailing address
4155 E HARRY ST, WICHITA, KS 67218-3725
(316) 665-2601
(316) 831-9569

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9974
KS

Other

Enumeration date
06/08/2016
Last updated
06/20/2016
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