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Individual

MS. PATRICIA JO WAHWASUCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
649 150TH ST, POWHATTAN, KS 66527-9632
(785) 741-4234
Mailing address
649 150TH ST, POWHATTAN, KS 66527-9632
(785) 741-4234

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
918
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
918
LAC
KS
Enumeration date
05/13/2021
Last updated
05/13/2021
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