Provider Demographics
NPI:1912672809
Name:KRIWIEL, TOBIN JAMES
Entity type:Individual
Prefix:
First Name:TOBIN
Middle Name:JAMES
Last Name:KRIWIEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TOBY
Other - Middle Name:
Other - Last Name:KRIWIEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:852 N CARTER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-3266
Mailing Address - Country:US
Mailing Address - Phone:316-209-6350
Mailing Address - Fax:
Practice Address - Street 1:120 N 6TH ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2243
Practice Address - Country:US
Practice Address - Phone:785-740-4647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist