Provider Demographics
NPI:1699723346
Name:OEHLERT, MARY E (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:OEHLERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:KS
Mailing Address - Zip Code:66043-0084
Mailing Address - Country:US
Mailing Address - Phone:816-863-5294
Mailing Address - Fax:
Practice Address - Street 1:4101 S 4TH ST TRAFFICWAY
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-5055
Practice Address - Country:US
Practice Address - Phone:913-682-2000
Practice Address - Fax:913-758-4267
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS774103T00000X
MOPY-01484103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist