Individual
MATTHEW PENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSCSW
Contact information
Practice address
101 E 1ST AVE, HUTCHINSON, KS 67501-7147
(620) 200-4800
Mailing address
PO BOX 772, HUTCHINSON, KS 67504-0772
(620) 200-4800
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4227
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000981201
—
KS
Enumeration date
09/04/2009
Last updated
10/07/2014
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