Provider Information for 1336667534
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KATHERINE E LIGHT LSCSW
Sex: Female
NPI: 1336667534
Last Updated: 2020-03-02
Certification Date: 2020-03-02
Certification Date: 2020-03-02
Details
Name | Value | ||||||||||||
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NPI | 1336667534 | ||||||||||||
Enumeration Date | 2017-09-07 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | NO | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 6000 LAMAR AVE STE 130 MISSION, KS 66202-3234 United States Phone: 913-826-4200 | Fax:913-826-1589 | ||||||||||||
Primary Practice Address | 6440 NIEMAN RD SHAWNEE, KS 66203-3326 United States Phone: 913-826-4200 | Fax:913-826-1589 | ||||||||||||
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