Provider Demographics
NPI:1922449578
Name:KRIGEL, SUSAN WAYNE (PHD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:WAYNE
Last Name:KRIGEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 SHAWNEE MISSION PKWY
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:FAIRWAY
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2528
Mailing Address - Country:US
Mailing Address - Phone:913-945-7534
Mailing Address - Fax:913-945-6644
Practice Address - Street 1:4350 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 1100
Practice Address - City:FAIRWAY
Practice Address - State:KS
Practice Address - Zip Code:66205-2528
Practice Address - Country:US
Practice Address - Phone:913-945-7534
Practice Address - Fax:913-945-6644
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2105103TC0700X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service