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)CodeLicenseStatePrimary
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

All providers in Rice, MN · Exclusive Provider Organization in Minnesota

Sources for this page

Verify at the official NPI Registry.