Provider Demographics
NPI:1477737997
Name:VANZANDT, ADRIENNE (MSFT, LMFT)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:VANZANDT
Suffix:
Gender:F
Credentials:MSFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N ROCK RD
Mailing Address - Street 2:130
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2203
Mailing Address - Country:US
Mailing Address - Phone:316-295-4757
Mailing Address - Fax:316-295-4750
Practice Address - Street 1:250 N ROCK RD
Practice Address - Street 2:130
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2203
Practice Address - Country:US
Practice Address - Phone:316-295-4757
Practice Address - Fax:316-295-4750
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMFT 916106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist