Provider Demographics
NPI:1619619012
Name:WEHRY, RACHEL JAQUETTA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:JAQUETTA
Last Name:WEHRY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:LEON
Mailing Address - State:KS
Mailing Address - Zip Code:67074-7416
Mailing Address - Country:US
Mailing Address - Phone:316-655-8088
Mailing Address - Fax:
Practice Address - Street 1:12828 E 13TH ST N STE 14
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-1466
Practice Address - Country:US
Practice Address - Phone:316-655-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10486104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker