Doctor Name: | DR. KENTON L. OLLIFF |
NPI Number: | 1174721211 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 339 |
Business Practice Address: | 124 E 12th St Hays, KS - 676013608 |
Business Phone Number: | 7856283575 |
Business Fax Number: | |
Mailing Address: | Po Box 475, HAYS |
State: | KS |
Postal Code: | 676010475 |
Phone Number: | 7856283575 |
Fax Number: | |
NPI Enumeration Date: | 07/10/2007 |
NPI Last Update Date: | 07/10/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 339 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |