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Individual

MRS. TABITHA BROOK PICKARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSCSW

Contact information

Practice address
555 N WOODLAWN ST, STUITE 102, WICHITA, KS 67208-3646
(316) 652-2590
(316) 652-2595
Mailing address
555 N WOODLAWN ST, STUITE 102, WICHITA, KS 67208-3646
(316) 652-2590
(316) 652-2595

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4459
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200621980B
KS
Enumeration date
07/16/2009
Last updated
07/10/2015
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