Doctor Name: | DANA KRUMWIEDE |
NPI Number: | 1003271008 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW, LAC |
License Number: | 1624 |
Business Practice Address: | 520 3rd St Nw Jamestown, ND - 584012968 |
Business Phone Number: | 7012536300 |
Business Fax Number: | 7012536400 |
Mailing Address: | Po Box 2055, JAMESTOWN |
State: | ND |
Postal Code: | 584022055 |
Phone Number: | 7012536300 |
Fax Number: | 7012536400 |
NPI Enumeration Date: | 12/18/2015 |
NPI Last Update Date: | 12/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1624 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ND |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |