Individual
NICOLE KAY BLOMBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMFT
Contact information
Practice address
200 W DOUGLAS AVE STE 555, WICHITA, KS 67202-3007
(316) 665-4710
Mailing address
200 W DOUGLAS AVE STE 555, WICHITA, KS 67202-3007
(316) 570-1995
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
3019
KS
106H00000X
Marriage & Family Therapist
3046
KS
106H00000X
Marriage & Family Therapist
Primary
3047
KS
Other
Enumeration date
11/13/2018
Last updated
11/05/2022
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