| Doctor Name: | AUDREY KAZMIERCZAK |
| NPI Number: | 1609026277 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LAC, LPCC, MAC |
| License Number: | LPCC93-7-1-91-65 |
| Business Practice Address: | 418 East Rosser Avenue Suite 304 Bismark, ND - 583014046 |
| Business Phone Number: | 7014711170 |
| Business Fax Number: | |
| Mailing Address: | 418 East Rosser Avenue, Suite 304 BISMARK |
| State: | ND |
| Postal Code: | 583014046 |
| Phone Number: | 7014711170 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2008 |
| NPI Last Update Date: | 09/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPCC93-7-1-91-65 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ND |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |