Individual
DR. ALICIA M LANDSVERK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LSCSW
Contact information
Practice address
1721 E OSAGE RD, STE 300, DERBY, KS 67037-2092
(316) 788-1907
(316) 788-1941
Mailing address
1721 E OSAGE RD STE 300, DERBY, KS 67037-2290
(316) 788-1907
(316) 788-1941
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1527
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100004880B
—
KS
Enumeration date
06/13/2005
Last updated
10/20/2011
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