Basic Information
| Provider Information | |||||||||
| NPI: | 1689916983 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VANGIESON | ||||||||
| FirstName: | DABRIA | ||||||||
| MiddleName: | CELESTE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2050 W 11TH ST N | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672033006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162675710 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2050 W 11TH ST N | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672033006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162675710 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2013 | ||||||||
| LastUpdateDate: | 03/25/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 2437 | KS | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.