Provider Demographics
NPI:1366264392
Name:DILLARD, RIA (LMSW-T)
Entity type:Individual
Prefix:
First Name:RIA
Middle Name:
Last Name:DILLARD
Suffix:
Gender:F
Credentials:LMSW-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 N RIVERVIEW ST STE 730
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-4267
Mailing Address - Country:US
Mailing Address - Phone:316-202-2110
Mailing Address - Fax:
Practice Address - Street 1:345 N RIVERVIEW ST STE 730
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4267
Practice Address - Country:US
Practice Address - Phone:316-202-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW13961-T104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty