Donitta L Gardiner

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · McConnell Afb, KS

NPI 1154345783 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154345783
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
57950 Leavenworth St
McConnell Afb, KS 67221-3506
Phone
(316) 759-5864
Fax
(316) 759-5038
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

57950 Leavenworth St
McConnell Afb, KS 67221-3506

Mailing address

57950 Leavenworth St
McConnell Afb, KS 67221-3506
Phone (316) 759-5864

Other providers in McConnell Afb, KS

All providers in McConnell Afb, KS · Addiction (Substance Use Disorder) Counselor in Kansas

Sources for this page

Verify at the official NPI Registry.