Doctor Name: | BRENDA L CERVANTES |
NPI Number: | 1447484761 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSCSW |
License Number: | 1171 |
Business Practice Address: | 600 Caisson Hill Rd Fort Riley, KS - 664427037 |
Business Phone Number: | 7852397208 |
Business Fax Number: | 7852397364 |
Mailing Address: | 600 Caisson Hill Rd, FORT RILEY |
State: | KS |
Postal Code: | 664427037 |
Phone Number: | 7852397208 |
Fax Number: | 7852397364 |
NPI Enumeration Date: | 05/14/2009 |
NPI Last Update Date: | 04/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1171 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |