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Individual

DEBRA LYNN VONDRACEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D

Contact information

Practice address
1301 KS HWY 264, LARNED, KS 67550-5353
(620) 285-4711
Mailing address
1301 KS HWY 264, LARNED, KS 67550-5353
(620) 285-4711

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 1433
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LP-1433
LICENSE NUMBER
KS
01
T-LP 1856
LICENSE NUMBER
KS
Enumeration date
01/20/2010
Last updated
11/22/2011
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