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General NPI Number Information
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NPI Number | 1083950844
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Entity Type | Individual
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Provider Name | BERNADINE JANZEN LPC
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Gender | Female
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Dates
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Enumeration Date | 12/26/2012
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Last Update Date | 12/26/2012
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Provider Practice Location Address
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Address Line | 5802 BOB BULLOCK LOOP STE C1 APT. 328C-101
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City | LAREDO
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State | TX
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Zip | 78041-8813
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Country | US
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Telephone | 387-761-0360
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Fax | 888-845-9302
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Provider Business Mailing Address
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Address Line | 5802 BOB BULLOCK LOOP STE C1 APT. 328C-101
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City | LAREDO
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State | TX
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Zip | 78041-8813
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Country | US
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Telephone | 387-761-0360
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Fax | 888-845-9302
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 410
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License Number State | AK
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