Provider Demographics
NPI:1336833185
Name:LAFLEN, KATHLEEN ANN (EDS)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:LAFLEN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:ANN
Other - Last Name:MICHELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDS
Mailing Address - Street 1:605 N STARK ST
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67422-9430
Mailing Address - Country:US
Mailing Address - Phone:785-342-1987
Mailing Address - Fax:
Practice Address - Street 1:605 N STARK ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:KS
Practice Address - Zip Code:67422-9430
Practice Address - Country:US
Practice Address - Phone:785-488-5106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9726732514103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool