Individual
DR. WANEKO CHANTELE BIVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MM, PHD
Contact information
Practice address
1524 W ELM ST, ANDOVER, KS 67002-9027
(302) 480-0573
Mailing address
1524 W ELM ST, ANDOVER, KS 67002-9027
(302) 480-0573
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
TH732068
MS
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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