Basic Information
| Provider Information | |||||||||
| NPI: | 1841565819 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOMBOSI | ||||||||
| FirstName: | BARBARA | ||||||||
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| Credential: | T-LMLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 N LORRAINE ST | ||||||||
| Address2: | 202 | ||||||||
| City: | HUTCHINSON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 675015670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206637595 | ||||||||
| FaxNumber: | 6206635263 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 N LORRAINE ST | ||||||||
| Address2: | 202 | ||||||||
| City: | HUTCHINSON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 675015670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206637595 | ||||||||
| FaxNumber: | 6206635263 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2012 | ||||||||
| LastUpdateDate: | 03/09/2012 | ||||||||
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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 | 103T00000X | 1439 | KS | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.