Basic Information
| Provider Information | |||||||||
| NPI: | 1861683294 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUTCHER | ||||||||
| FirstName: | SUSAN | ||||||||
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| Credential: | PSYD, T-LP, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9333 E | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 67206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162932647 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1204 BSELOUIS DR | ||||||||
| Address2: | |||||||||
| City: | MULVANE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 67110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3163518696 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2007 | ||||||||
| LastUpdateDate: | 11/20/2015 | ||||||||
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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 | 103TC0700X | 1982 | KS | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.