Provider Demographics
NPI:1114707395
Name:COULTIS, NORA PLUMB (PHD)
Entity Type:Individual
Prefix:DR
First Name:NORA
Middle Name:PLUMB
Last Name:COULTIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:KENDALL
Other - Last Name:PLUMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:13713 MANOR
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-4523
Mailing Address - Country:US
Mailing Address - Phone:918-630-7186
Mailing Address - Fax:
Practice Address - Street 1:7501 COLLEGE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2505
Practice Address - Country:US
Practice Address - Phone:913-451-8550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLP03246103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical