Organization
KANSAS CHILDREN'S SERVICE LEAGUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA CORNWELL LCMFT (CLINICAL SUPERVISOR)
(316) 942-4261
Entity
Organization
Contact information
Practice address
1365 N. CUSTER, WICHITA, KS 67203
(316) 942-4261
(316) 943-9995
Mailing address
1365 N. CUSTER, WICHITA, KS 67203
(316) 942-4261
(316) 943-9995
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
513
KS
Other
Enumeration date
05/09/2007
Last updated
08/22/2020
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