Provider Demographics
NPI:1295027068
Name:VAN LENT, BOBBI JO (PLADC)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:JO
Last Name:VAN LENT
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX A
Mailing Address - Street 2:
Mailing Address - City:WINNEBAGO
Mailing Address - State:NE
Mailing Address - Zip Code:68071-0841
Mailing Address - Country:US
Mailing Address - Phone:402-878-2480
Mailing Address - Fax:402-878-2204
Practice Address - Street 1:PO BOX A
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:NE
Practice Address - Zip Code:68071-0841
Practice Address - Country:US
Practice Address - Phone:402-878-2480
Practice Address - Fax:402-878-2204
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-826101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)