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Individual
CYNTHIA LEE WILLENBROCK
Active
Individual
CYNTHIA LEE WILLENBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LAC, PCLC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
306543
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
63194
MT
101YM0800X
Mental Health Counselor
64741
MT
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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