| Doctor Name: | MRS. INGRID FAVIOLA PONCIANO |
| NPI Number: | 1114230703 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMFT |
| License Number: | 1163 |
| Business Practice Address: | 527 Commercial Suite 517 Emporia, KS - 668014081 |
| Business Phone Number: | 6203424473 |
| Business Fax Number: | 6203421157 |
| Mailing Address: | 527 Commercial, Suite 517 EMPORIA |
| State: | KS |
| Postal Code: | 668014081 |
| Phone Number: | 6203424473 |
| Fax Number: | 6203421157 |
| NPI Enumeration Date: | 07/23/2010 |
| NPI Last Update Date: | 10/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1163 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |