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DONITTA L GARDINER

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1154345783

Individual Registrant:
 DONITTA L GARDINER 
Gender: F
Sole Proprietor

Location and contact information for practice:
57950 LEAVENWORTH ST  MCCONNELL AFB, KS 67221-3506 US
Tel: 316-759-5864  Fax: 316-759-5038

Contact information for business:
57950 LEAVENWORTH ST  MCCONNELL AFB, KS 67221-3506 US
Tel: 316-759-5864  Fax: 316-759-5038

Registration Information:
NPI: 1154345783
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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