Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
WALLACE LARRY KLOSTREICH, LAC
ActiveAddiction (Substance Use Disorder) Counselor · BISMARCK, ND
Registration Details
- NPI Number
- 1073540415
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 28, 2006 (19.816938670198 yrs)
- Last Updated
- Jul 8, 2007
- License
-
1073 (ND)
Practice Information
- Address
-
1237 W DIVIDE AVESTE 5BISMARCK, ND, 585011208Browse ND providers · Browse ZIP 58501
- Phone
- 7013288892
- Fax
- 7013288900
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Other Addiction (Substance Use Disorder) Counselor Providers in BISMARCK, ND
| Name | Credential | NPI |
|---|---|---|
| MS. PENNY DAWN WEDIN-GORDEN | LICSW,LAC | 1093757205 |
| EDWARD KEHRWALD | PHD, LAC | 1780627489 |
| MICHELLE GAYETTE | LAC | 1629014287 |
| DAVID MICKELSON | MS/LAC | 1356387534 |
| SUE A MOCK | LAC | 1023054210 |
| SHELLEY KAY BUFFINGTON | LAC | 1114956471 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.