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General NPI Number Information
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NPI Number | 1346730017
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Entity Type | Organization
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Legal Business Name | ART OF REDIRECTION COUNSELING
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Dates
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Enumeration Date | 05/17/2018
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Last Update Date | 05/17/2018
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Provider Practice Location Address
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Address Line | 6821 MAIN ST STE C
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City | BONNERS FERRY
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State | ID
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Zip | 83805-8552
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Country | US
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Telephone | 208-267-9228
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Fax | 208-267-9228
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Provider Business Mailing Address
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Address Line | 6821 MAIN ST STE C
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City | BONNERS FERRY
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State | ID
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Zip | 83805-8552
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Country | US
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Telephone | 208-267-9228
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Fax | 208-267-9228
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Authorized Official
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Title or Position | OWNER AND CLINICAL THERAPIST
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Name | KATHRYN L WENZEL
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Credential | LCSW
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Telephone | 208-267-9228
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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 | 36243
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 36243
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License Number State | ID
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