Organization · Type 2 NPI

Blue Moon Therapy LLC

Mental Health Clinic/Center (Including Community Mental Health Center) · Wichita, KS

NPI number 1205319472 Active

Practice location

400 N Woodlawn, Suite 100
Wichita, KS 67216-1360

Call (316) 652-2580 Map

Mailing address

1215 E Jump St
Wichita, KS 67216-1360

Specialties and licenses

TaxonomyCodeLicense
Mental Health Clinic/Center (Including Community Mental Health Center) Primary 261QM0801XNone listed

Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...

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About NPI 1205319472

Blue Moon Therapy LLC's National Provider Identifier is 1205319472, issued on Sep 12, 2018. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Wichita, KS. The record was last updated on Sep 12, 2018.