Individual
VICKIE FARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
304 N CHURCH ST, HAZELTON, KS 67061-9300
(620) 239-4031
(620) 239-4032
Mailing address
PO BOX 103, KIOWA, KS 67070-0103
(620) 239-4031
(620) 239-4032
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LADC 103
OK
101YM0800X
Mental Health Counselor
Primary
03283
KS
101YM0800X
Mental Health Counselor
LPC 3783
OK
Other
Enumeration date
05/21/2007
Last updated
08/10/2022
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