Doctor Name: | MRS. SYLVIA IVONNE MAACK |
NPI Number: | 1104148261 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ED.S., LCP |
License Number: | 6911447291 |
Business Practice Address: | 304 West St Tonganoxie, KS - 660869714 |
Business Phone Number: | 9134177061 |
Business Fax Number: | 9134177062 |
Mailing Address: | 2232 Melholland Rd, LAWRENCE |
State: | KS |
Postal Code: | 660472340 |
Phone Number: | 7853302540 |
Fax Number: | |
NPI Enumeration Date: | 02/17/2010 |
NPI Last Update Date: | 02/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 6911447291 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |