Provider Demographics
NPI:1760639298
Name:KIDNEY, JAIDA NICOLE (LMFTT)
Entity Type:Individual
Prefix:MRS
First Name:JAIDA
Middle Name:NICOLE
Last Name:KIDNEY
Suffix:
Gender:F
Credentials:LMFTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 GAGE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604
Mailing Address - Country:US
Mailing Address - Phone:785-272-0778
Mailing Address - Fax:785-272-0778
Practice Address - Street 1:2000 GAGE BOULEVARD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604
Practice Address - Country:US
Practice Address - Phone:785-272-0778
Practice Address - Fax:785-272-0778
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS984106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist