Individual
DARBY MICHAEL PENTECOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
551 S HOLLAND LN, WICHITA, KS 67209-2007
(316) 796-5776
Mailing address
551 S HOLLAND LN, WICHITA, KS 67209-2007
(316) 796-5776
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1692
KS
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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