Individual
MYISHA ANTOINETTE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 E CENTRAL AVE STE 2, WICHITA, KS 67214-3344
(316) 807-6879
Mailing address
2501 E CENTRAL AVE STE 2, WICHITA, KS 67214-3344
(316) 807-6879
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
12151-T
KS
104100000X
Social Worker
Primary
12845
KS
Other
Enumeration date
08/23/2021
Last updated
03/15/2023
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