Provider Demographics
NPI:1134482854
Name:VANWINKLE, DANA M (LAC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:VANWINKLE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:345 S HYDRAULIC ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-1908
Mailing Address - Country:US
Mailing Address - Phone:316-260-9101
Mailing Address - Fax:163-260-9103
Practice Address - Street 1:830 S HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-3004
Practice Address - Country:US
Practice Address - Phone:316-613-2222
Practice Address - Fax:316-613-2220
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS358101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)