Individual
SHELBY PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
4155 E HARRY ST, WICHITA, KS 67218-3725
(800) 423-1342
(785) 628-3113
Mailing address
509 E ELM ST, SALINA, KS 67401-2353
(800) 423-1342
(785) 628-3113
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2819
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201140800B
—
KS
Enumeration date
12/11/2015
Last updated
09/23/2019
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