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General NPI Number Information
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NPI Number | 1720269392
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Entity Type | Individual
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Provider Name | AMY NATHE LPCC
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Gender | Female
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Dates
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Enumeration Date | 11/23/2007
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Last Update Date | 05/11/2018
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Provider Practice Location Address
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Address Line | 26246 CRANE RD
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City | WHITE EARTH
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State | MN
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Zip | 56591-9998
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Country | US
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Telephone | 218-983-3286
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Fax |
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Provider Business Mailing Address
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Address Line | 14445 HIGHWAY 10
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City | GLYNDON
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State | MN
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Zip | 56547-9565
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Country | US
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Telephone | 701-212-2758
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CC00086
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License Number State | MN
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