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General NPI Number Information
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NPI Number | 1316761463
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Entity Type | Organization
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Legal Business Name | DEVRIES COUNSELING SERVICES PC
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 3101 8TH ST S
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City | MOORHEAD
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State | MN
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Zip | 56560-5062
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Country | US
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Telephone | 701-941-0175
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 8TH ST S
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City | MOORHEAD
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State | MN
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Zip | 56560-5062
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Country | US
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Telephone | 804-629-2260
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HOLLY DEVRIES
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Credential | LPC
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Telephone | 804-629-2260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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