Organization
SOUTH CENTRAL MENTAL HEALTH COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REGINA CORCIMIGLIA (HR SPECIALIST)
(316) 755-5491
Entity
Organization
Contact information
Practice address
2365 W CENTRAL AVE, EL DORADO, KS 67042-3208
(316) 321-6036
Mailing address
2365 W CENTRAL AVE, EL DORADO, KS 67042-3208
(316) 321-6036
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
T-LMLP 2425
KS
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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