MEDICARE: VIEAU COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1366896557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIEAU COUNSELING

Provider Business Mailing Address
First Line	:	302 E HOWARD ST STE 327
Second Line	:
City	:	HIBBING
State	:	MN
Zip	:	55746-1772
Country	:	US
Telephone Number	:	218-235-1703
Fax Number	:	218-440-1278

Provider Business Practice Location Address
First Line	:	302 E HOWARD ST STE 327
Second Line	:
City	:	HIBBING
State	:	MN
Zip	:	55746-1772
Country	:	US
Telephone Number	:	218-235-1703
Fax Number	:	218-440-1278

Authorized Official
Title or Position	:	OWNER
Name	:	CASEY MICHELLE BOSCH
Credential	:	MS
Telephone Number	:	218-235-1703

Provider Enumeration Date	:	04/14/2016
Last Update Date	:	04/14/2016

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