Provider Demographics
NPI:1063245918
Name:HERMOSILLO, ALONDRA (LMFT-T)
Entity type:Individual
Prefix:
First Name:ALONDRA
Middle Name:
Last Name:HERMOSILLO
Suffix:
Gender:F
Credentials:LMFT-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N ROCK RD STE 150
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2241
Mailing Address - Country:US
Mailing Address - Phone:316-208-8280
Mailing Address - Fax:
Practice Address - Street 1:250 N ROCK RD STE 150
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2241
Practice Address - Country:US
Practice Address - Phone:316-208-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-24
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03617-T106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist