Organization
ERIN IS HOPE FOUNDATION INC
Active
Other names
Pollard-Licklider Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY LYNN POLLARD-LICKLIDER MA CCC SLP (PRESIDENT)
(316) 681-3204
Entity
Organization
Contact information
Practice address
4921 E 21ST ST N, WICHITA, KS 67208-1602
(316) 681-3204
(316) 681-0541
Mailing address
4921 E 21ST ST N, WICHITA, KS 67208-1602
(316) 681-3204
(316) 681-0541
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
3582
KS
225X00000X
Occupational Therapist
17-02079
KS
225X00000X
Occupational Therapist
17-02321
KS
235Z00000X
Speech-Language Pathologist
2304
KS
235Z00000X
Speech-Language Pathologist
2757
KS
235Z00000X
Speech-Language Pathologist
2900
KS
235Z00000X
Speech-Language Pathologist
Primary
998
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115161
BLUE CROSS BLUE SHIELD
KS
05
—
20031630B
—
KS
Enumeration date
05/20/2006
Last updated
01/14/2011
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