Organization
CHILD PSYCHIATRY LLC
Active
Organization
CHILD PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE HAUSHEER M.D. (OWNER)
(620) 626-4600
Entity
Organization
Contact information
Practice address
30 PLAZA DR, LIBERAL, KS 67901-2743
(620) 626-4600
(620) 626-4602
Mailing address
PO BOX 915, LIBERAL, KS 67905-0915
(620) 626-4600
(620) 626-4602
Taxonomy
Speciality
Code
Description
License number
State
2084P0005X
Neurodevelopmental Disabilities Physician
04-29570
KS
2084P0800X
Psychiatry Physician
Primary
04-29570
KS
2084P0804X
Child & Adolescent Psychiatry Physician
04-29570
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104222
BCBS INDIVIDUAL
KS
01
—
111102
BCBS GROUP
KS
Enumeration date
03/23/2007
Last updated
06/02/2008
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