Individual
LYDIA CHAVEZ-CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2807 N FOREST PARK ST, DERBY, KS 67037-7912
(316) 214-8006
Mailing address
2807 N FOREST PARK ST, DERBY, KS 67037-7912
(316) 214-8006
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9898
KS
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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