Individual
JESSICA L HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 S BROADWAY ST, WICHITA, KS 67202-4304
(316) 267-5437
(316) 267-5444
Mailing address
340 S BROADWAY ST, WICHITA, KS 67202-4304
(316) 267-5437
(316) 267-5444
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/08/2009
Last updated
06/08/2009
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