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General NPI Number Information
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NPI Number | 1639358740
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Entity Type | Individual
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Provider Name | DARLA FAYE KLOEPFFER M.A. CADC
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Gender | Female
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 10/25/2007
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Provider Practice Location Address
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Address Line | 15251 PLEASANT VALLEY RD
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City | CENTER CITY
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State | MN
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Zip | 55012-9640
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Country | US
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Telephone | 651-213-4403
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Fax |
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Provider Business Mailing Address
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Address Line | 1143 7TH AVE SW APT 205
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City | FOREST LAKE
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State | MN
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Zip | 55025-1746
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Country | US
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Telephone | 847-924-1377
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 23339
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License Number State | IL
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