Individual
RENA COLE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
940 N WACO AVE, WICHITA, KS 67203-3947
(316) 660-7550
(316) 383-8241
Mailing address
635 N MAIN ST, WICHITA, KS 67203-3602
(316) 660-7600
(316) 383-7925
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0576
KS
103TC0700X
Clinical Psychologist
294
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
389900
BLUE CROSS BLUE SHIELD
KS
01
—
9460
PREFERRED HEALTH SYSTEMS
KS
Enumeration date
05/17/2006
Last updated
07/08/2007
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