Individual
BREANNE LARAE WASINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1005 W 14TH ST N, WICHITA, KS 67203-2745
(316) 262-5424
Mailing address
1005 W 14TH ST N, WICHITA, KS 67203-2745
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/05/2008
Last updated
12/05/2008
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