Doctor Name: | CONNIE KREIZENBECK |
NPI Number: | 1700165628 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.COUN, LPC |
License Number: | LPC-4783 |
Business Practice Address: | 409 Washington Ave. Pocatello, ID - 83201 |
Business Phone Number: | 2082342646 |
Business Fax Number: | |
Mailing Address: | 1045 Holman Ave, POCATELLO |
State: | ID |
Postal Code: | 832012965 |
Phone Number: | 2082847342 |
Fax Number: | |
NPI Enumeration Date: | 08/09/2011 |
NPI Last Update Date: | 08/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPC-4783 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |