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ATHNASIA KLOCKE MA

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1427540707

Individual Registrant:
 ATHNASIA  KLOCKE MA
Gender: F
Not Sole Proprietor

Location and contact information for practice:
15694 DODGE MOWER RD  HAYFIELD, MN 55940-8438 US
Tel: 507-251-5008  Fax: --

Contact information for business:
15694 DODGE MOWER RD  HAYFIELD, MN 55940-8438 US
Tel: 507-251-5008  Fax: --

Registration Information:
NPI: 1427540707
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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