Individual
COURTNEY NICOLE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
635 N MAIN ST, WICHITA, KS 67203-3602
(316) 660-7500
Mailing address
1003 W CLYDE ST, ANDOVER, KS 67002-7811
(316) 285-3698
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
3065
KS
Other
Enumeration date
09/30/2018
Last updated
06/10/2020
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