| Doctor Name: | PATRICIA A WANZENRIED |
| NPI Number: | 1215009139 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LMHC, DMHP |
| License Number: | LH00003900 |
| Business Practice Address: | 165 E Hawthorne Ave Colville, WA - 991142629 |
| Business Phone Number: | 5096844597 |
| Business Fax Number: | |
| Mailing Address: | 175 E Fifth Street, KETTLE FALLS |
| State: | WA |
| Postal Code: | 99141 |
| Phone Number: | 5097382469 |
| Fax Number: | |
| NPI Enumeration Date: | 11/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LH00003900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |