Provider Demographics
NPI:1407471840
Name:WONDRA, JOANNE R (LPC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:R
Last Name:WONDRA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 11TH ST
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-4419
Mailing Address - Country:US
Mailing Address - Phone:620-796-2788
Mailing Address - Fax:620-796-2789
Practice Address - Street 1:2008 11TH ST
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-4419
Practice Address - Country:US
Practice Address - Phone:620-796-2788
Practice Address - Fax:620-796-2789
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional