Individual
MRS. STACY LYNETTE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1501 N MERIDIAN AVE, WICHITA, KS 67203-1942
(316) 942-3221
(316) 942-1750
Mailing address
1501 N MERIDIAN AVE, WICHITA, KS 67203-1942
(316) 942-3221
(316) 942-1750
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6066
KS
Other
Enumeration date
06/11/2007
Last updated
07/08/2007
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