Doctor Name: | MRS. KIM M HERMAN |
NPI Number: | 1104917301 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CSW,CADCIII |
License Number: | 1389 |
Business Practice Address: | 199 Home Rd Juneau, WI - 530391401 |
Business Phone Number: | 9203863500 |
Business Fax Number: | 9203863812 |
Mailing Address: | 199 Home Rd, JUNEAU |
State: | WI |
Postal Code: | 530391401 |
Phone Number: | 9203863500 |
Fax Number: | 9203863812 |
NPI Enumeration Date: | 09/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1389 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |