Doctor Name: | DARRYN HAUDRICH |
NPI Number: | 1144642026 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 178.006744 |
Business Practice Address: | 988 N Illinois Route 3 Waterloo, IL - 622981000 |
Business Phone Number: | 6189394444 |
Business Fax Number: | 6189394181 |
Mailing Address: | 988 N Illinois Route 3, Po Box 146 WATERLOO |
State: | IL |
Postal Code: | 622981000 |
Phone Number: | 6189394444 |
Fax Number: | 6189394184 |
NPI Enumeration Date: | 01/13/2014 |
NPI Last Update Date: | 01/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 178.006744 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |