Organization
WESLEY S SMOTHERMON
Active
Parent organization
WESLEY S SMOTHERMON
Other names
Wesley S Smothermon
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESLEY S SMOTHERMON
Authorized official
WESLEY S SMOTHERMON M.A (TLMFT, CPT)
(316) 648-9580
Entity
Organization
Contact information
Practice address
2801 W 15TH ST N, WICHITA, KS 67203-1833
(316) 648-9580
Mailing address
2801 W 15TH ST N, WICHITA, KS 67203-1833
(316) 648-9580
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
KO1-14-3203
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201142440A
—
KS
Enumeration date
02/27/2017
Last updated
02/27/2017
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