Provider Demographics
NPI:1487139903
Name:LENTZ, TARYN ACOSTA (PHD)
Entity type:Individual
Prefix:DR
First Name:TARYN
Middle Name:ACOSTA
Last Name:LENTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:TARYN
Other - Middle Name:JENSEN
Other - Last Name:ACOSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:G116 STUDENT CENTER, MAIL STOP 4006
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-7351
Mailing Address - Fax:913-588-6597
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:G116 STUDENT CENTER, MAIL STOP 4006
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-7351
Practice Address - Fax:913-588-6597
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2412103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist