Individual
MRS. LAURIE DANAE THEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
123 E MAIN ST, FREDERICKSBURG, IA 50630-7701
(563) 237-5157
(319) 865-3110
Mailing address
123 E MAIN ST, PO BOX 155, FREDERICKSBURG, IA 50630-7701
(563) 237-5157
(319) 865-3110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00725
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203580
—
IA
05
—
1203580
—
IA
Enumeration date
05/09/2008
Last updated
12/01/2009
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