Provider Demographics
NPI:1033373345
Name:KLAUS, NICOLE M (PHD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:KLAUS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:M
Other - Last Name:WASINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1010 N KANSAS
Mailing Address - Street 2:SUITE #3049
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3199
Mailing Address - Country:US
Mailing Address - Phone:316-293-2647
Mailing Address - Fax:316-293-1863
Practice Address - Street 1:1001 N MINNEAPOLIS
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3199
Practice Address - Country:US
Practice Address - Phone:316-293-2647
Practice Address - Fax:316-293-1863
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1735103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent