Individual
ANA IVETTE VALLECILLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
426 S COTTONWOOD ST, EMPORIA, KS 66801-4848
(620) 757-9399
Mailing address
426 S COTTONWOOD ST, EMPORIA, KS 66801-4848
(620) 757-9399
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
T-LPC3356
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T-LPC3356
—
KS
Enumeration date
01/08/2019
Last updated
01/08/2019
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