Organization Name: | WB COUNSELING LLC |
NPI Number: | 1033480470 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WALDA G. BOURGE (OWNER) |
Mailing Address: | 319 E. B St. North Platte |
State: | NE US |
Postal Code: | 69101 |
Phone Number: | 3085325565 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2012 |
NPI Last Update Date: | 01/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 3284 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |