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General NPI Number Information
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NPI Number | 1255486718
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Entity Type | Individual
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Provider Name | KANDY PAULINE KONRUFF LMHP
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 509 E 4TH ST STE C
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6943
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Country | US
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Telephone | 308-520-4213
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 731
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City | NORTH PLATTE
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State | NE
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Zip | 69103
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Country | US
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Telephone | 308-520-4213
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1575
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License Number State | NE
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