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Individual

CRISTIN PATENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., LMHC, PLADC

Contact information

Practice address
1303 GARFIELD AVE, HARLAN, IA 51537-2063
(712) 755-5056
Mailing address
1213 GARFIELD AVE, HARLAN, IA 51537-2057
(712) 755-5056
(712) 755-7143

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10655
NE
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
T-088101
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1174991715
IA
Enumeration date
09/14/2015
Last updated
07/21/2022
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