Individual provider · Type 1 NPI

Wallace Larry Klostreich, LAC

Addiction (Substance Use Disorder) Counselor · Bismarck, ND

NPI number 1073540415 Active

Practice location

1237 W Divide Ave, Ste 5
Bismarck, ND 58501-1208

Call (701) 328-8892 Map

Fax (701) 328-8900

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X1073 (ND)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1073540415

Wallace Larry Klostreich, LAC's National Provider Identifier is 1073540415, issued on Jun 28, 2006. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Bismarck, ND. The record was last updated on Jul 8, 2007.