Individual
ODRIKUS DONJUAN WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1525 N BUCKNER ST, DERBY, KS 67037-2948
(316) 788-6464
(206) 299-1262
Mailing address
1525 N BUCKNER ST, DERBY, KS 67037-2948
(316) 788-6464
(206) 299-1262
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
04166
KS
101YM0800X
Mental Health Counselor
11965
OK
101YP2500X
Professional Counselor
Primary
04166
KS
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/11/2022
Last updated
04/21/2026
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