Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 4748 | WI |
N | 225XM0800X | Mental Health | 4748-026 | WI |
NPI | 1730494337 |
---|---|
Provider Name | Mrs. Erin M Hebrink |
First Address | La Crosse, WI 54601-4783 |
Second Address | La Crosse, WI 54601-4783 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2010 |
Last Update Date | 08/03/2011 |