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Individual

JERRY LEE VADNAIS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MS, LCMFT

Contact information

Practice address
345 RIVERVIEW ST, SUITE LL2, WICHITA, KS 67203-4200
(316) 262-5253
(316) 262-7202
Mailing address
345 RIVERVIEW ST, SUITE LL2, WICHITA, KS 67203-4200
(316) 262-5253
(316) 262-7202

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
282
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007517280
AETNA USHC
KS
01
024438
VMC
KS
01
318913
MANAGED HEALTH NETWORK
KS
01
373150
BCBS
KS
Enumeration date
09/14/2005
Last updated
07/08/2007
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