Organization Name: | ROBYN WATCHORN NEWBREY, LLC |
NPI Number: | 1174914360 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBYN LYNN WATCHORN NEWBREY (OWNER) |
Mailing Address: | 3900 Dakota Ave Suite 4b South Sioux City |
State: | NE US |
Postal Code: | 687763696 |
Phone Number: | 7123016529 |
Fax Number: | 4029257200 |
NPI Enumeration Date: | 02/10/2015 |
NPI Last Update Date: | 07/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 1291 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |