Doctor Name: | MR. LLOYD BURTON HANNEMANN |
NPI Number: | 1306016498 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA MFT |
License Number: | RC00026985 |
Business Practice Address: | 1 Colville St Nespelem, WA - 991550150 |
Business Phone Number: | 5096342611 |
Business Fax Number: | 5096342781 |
Mailing Address: | Po Box 216, MALO |
State: | WA |
Postal Code: | 991500216 |
Phone Number: | 5096342611 |
Fax Number: | 5096342781 |
NPI Enumeration Date: | 03/05/2008 |
NPI Last Update Date: | 03/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | RC00026985 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |