Provider Demographics
NPI:1053407015
Name:STRICKLER, TAPATHA K (TLMLP)
Entity type:Individual
Prefix:
First Name:TAPATHA
Middle Name:K
Last Name:STRICKLER
Suffix:
Gender:F
Credentials:TLMLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 W NICKERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:NICKERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67561-9054
Mailing Address - Country:US
Mailing Address - Phone:620-422-3881
Mailing Address - Fax:
Practice Address - Street 1:1715 E 23RD AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1105
Practice Address - Country:US
Practice Address - Phone:620-665-2240
Practice Address - Fax:620-665-2276
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1103103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS835067OtherBCBS