Individual
THIEN PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1919 N AMIDON AVE, STE 130, WICHITA, KS 67203-2117
(316) 660-7675
(316) 832-1571
Mailing address
934 N WATER ST, WICHITA, KS 67203-3838
(316) 660-7600
(316) 941-5075
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
124789
KS
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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