Individual
MR. BRYAN SPENCER BROCKUS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT-T
Contact information
Practice address
622 E DOUGLAS AVE, WICHITA, KS 67202-3504
(316) 312-5560
Mailing address
622 E DOUGLAS AVE, WICHITA, KS 67202-3504
(316) 312-5560
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
03289-T
KS
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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