Doctor Name: | MS. LAURA JEAN VANDENBERG |
NPI Number: | 1518039619 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LADC |
License Number: | 422 |
Business Practice Address: | 729 Seward St Suite 2 Seward, NE - 68434 |
Business Phone Number: | 4026433343 |
Business Fax Number: | 4026434048 |
Mailing Address: | 459 South 6th, Street, Suite 1, SEWARD |
State: | NE |
Postal Code: | 68434 |
Phone Number: | 4026433343 |
Fax Number: | |
NPI Enumeration Date: | 11/14/2006 |
NPI Last Update Date: | 09/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 422 |
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: |