Doctor Name: | DANA L VANDERGIESSEN |
NPI Number: | 1760627657 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | LCPC4166 |
Business Practice Address: | 2770 E Franklin Rd Meridian, ID - 836425953 |
Business Phone Number: | 2088550660 |
Business Fax Number: | 2088989433 |
Mailing Address: | 355 Stagecoach Way, KUNA |
State: | ID |
Postal Code: | 836342341 |
Phone Number: | 2084203199 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2008 |
NPI Last Update Date: | 12/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LCPC4166 |
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 |