Individual
MR. GREGORY TODD HENNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3751 W MAIN ST, INDEPENDENCE, KS 67301-8446
(620) 331-1748
Mailing address
PO BOX 688, INDEPENDENCE, KS 67301-0688
(620) 331-1748
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
095
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200435900A
—
KS
Enumeration date
07/17/2006
Last updated
05/28/2024
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