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General NPI Number Information
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NPI Number | 1437217643
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Entity Type | Organization
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Legal Business Name | LYNN E FLINT WIDDIFIELD
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 1811 W 2ND ST SUITE 310
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City | GRAND ISLAND
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State | NE
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Zip | 68803-5464
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Country | US
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Telephone | 308-381-0787
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Fax | 308-381-4632
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Provider Business Mailing Address
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Address Line | 1811 W 2ND ST SUITE 310
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City | GRAND ISLAND
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State | NE
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Zip | 68803-5413
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Country | US
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Telephone | 308-381-0787
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Fax | 308-381-4632
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Authorized Official
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Title or Position | OWNER SOLE THERAPIST
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Name | MRS. LYNN E FLINT WIDDIFIELD
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Credential | LMHP ATR BC
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Telephone | 308-381-0787
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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 | 1209
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License Number State | NE
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