Doctor Name: | BOBBI JO VAN LENT |
NPI Number: | 1295027068 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PLADC |
License Number: | P-826 |
Business Practice Address: | Po Box A Winnebago, NE - 680710841 |
Business Phone Number: | 4028782480 |
Business Fax Number: | 4028782204 |
Mailing Address: | Po Box A, WINNEBAGO |
State: | NE |
Postal Code: | 680710841 |
Phone Number: | 4028782480 |
Fax Number: | 4028782204 |
NPI Enumeration Date: | 05/11/2011 |
NPI Last Update Date: | 05/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | P-826 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |