Provider Demographics
NPI:1184856387
Name:CHILDS, SACHA ANNE
Entity Type:Individual
Prefix:MRS
First Name:SACHA
Middle Name:ANNE
Last Name:CHILDS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SACHA
Other - Middle Name:ANNE
Other - Last Name:HAUKENBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-0517
Mailing Address - Country:US
Mailing Address - Phone:316-942-4261
Mailing Address - Fax:316-943-9995
Practice Address - Street 1:3545 SW 5TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1904
Practice Address - Country:US
Practice Address - Phone:785-274-3100
Practice Address - Fax:785-274-3824
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCMFT 287106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist