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MRS. JACCI RAE KOERNER TLMLP
>> Psychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1700991494
Individual Registrant:MRS. JACCI RAE KOERNER TLMLP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
610 E GRANT AVE GREENSBURG, KS 67054-2708 US
Tel: 620-723-2272 Fax: 620-723-3450
Tel: 620-723-2272 Fax: 620-723-3450
Contact information for business:
207 W WISCONSIN AVE GREENSBURG, KS 67054-1750 US
Tel: 620-723-2214 Fax: --
Tel: 620-723-2214 Fax: --
Registration Information:
NPI: 1700991494
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103T00000X | Behavioral Health & Social Service Providers Psychologist | KS | TLMLP 1020 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
