Individual
AMIE KOPISCHKE STAMBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LAC
Contact information
Practice address
555 N WOODLAWN ST STE 3105, WICHITA, KS 67208-3673
(316) 685-1821
(316) 685-0768
Mailing address
1427 N DRY CREEK CT, DERBY, KS 67037-2831
(316) 685-1821
(316) 685-0768
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
430
KS
101YP2500X
Professional Counselor
Primary
2258
KS
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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