Wallace Larry Klostreich, LAC
NPI #1073540415 in Bismarck, North Dakota
Provider Information
- NPI Number
- 1073540415
- Entity Type
- Individual
- Name
- Wallace Larry Klostreich, LAC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- LAC
- Enumeration Date
- Jun 28, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1237 W DIVIDE AVE
- Address 2
- STE 5
- City
- Bismarck
- State
- North Dakota
- ZIP Code
- 58501-1208
- Phone
- (701) 328-8892
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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