Derstein, Jacklyn R

Derstein, Jacklyn R is an sole proprietor health care provider with primary practice located at 2604 W 9Th St N , Wichita KS 67203-4731. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Derstein, Jacklyn R can be contacted via phone (316) 295-4758.

Contact Information

Primary practice address
2604 W 9Th St N Wichita KS 67203-4731
Phone: (316) 295-4758
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1250 Kansas

Profile Details

NPI number 1407123680
LBN Legal business name Derstein, Jacklyn R
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 16th, 2011
Last updated Nov 16th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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