Halbur/Witham, LLC
Organization Active NPI Exclusive Provider Organization · Rice, MN
NPI 1912440256 · NPPES record last updated Nov 18, 2016
Key facts
- NPI
- 1912440256
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Exclusive Provider Organization 302F00000X
- License
- 106H00000X (MN)
- Legal business name
- HALBUR/WITHAM, LLC
- Practice address
- 2623 125TH St NE
Rice, MN 56367-9746 - Phone
- (320) 260-6755
- NPI assigned
- Nov 18, 2016
- Organization subpart
- No
Authorized official
- Name
- Mrs. Jeannette C. Witham, LMFT
- Title
- Clinical Supervisor
- Phone
- (320) 282-0112
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | 106H00000X | MN | Yes |
Addresses
Primary practice location
2623 125TH St NE
Rice, MN 56367-9746
Mailing address
65189 365TH St
Watkins, MN 55389-6054
Phone (320) 224-1407
Other providers in Rice, MN
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- Seth Dahle
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- Jeffrey Gordon Hyytinen
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All providers in Rice, MN · Exclusive Provider Organization in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.