| Doctor Name: | VICKIE DIANE BRASS |
| NPI Number: | 1093847410 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 992 |
| Business Practice Address: | 11200 Lariat Way Dodge City, KS - 678017328 |
| Business Phone Number: | 6202250276 |
| Business Fax Number: | 6202275219 |
| Mailing Address: | 4505 E 47th St S, WICHITA |
| State: | KS |
| Postal Code: | 672101651 |
| Phone Number: | 3165299100 |
| Fax Number: | 3165299351 |
| NPI Enumeration Date: | 03/12/2007 |
| NPI Last Update Date: | 08/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 992 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |