Provider Demographics
NPI:1649464702
Name:GALBREATH, VANESSA YVETTE (LMSW)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:YVETTE
Last Name:GALBREATH
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 1:1883 W 21ST ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-2104
Mailing Address - Country:US
Mailing Address - Phone:316-832-0277
Mailing Address - Fax:316-838-5658
Practice Address - Street 1:1883 W 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-2104
Practice Address - Country:US
Practice Address - Phone:316-832-0277
Practice Address - Fax:316-838-5658
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW 5534104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker