Provider Demographics
NPI:1750482139
Name:KREBSBACH FLOREY, JANICE S (MSW LICSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:S
Last Name:KREBSBACH FLOREY
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 1ST ST N
Mailing Address - Street 2:RANGE MENTAL HEALTH CENTER BELL BUILDING
Mailing Address - City:VIRGINIA
Mailing Address - State:MN
Mailing Address - Zip Code:55792
Mailing Address - Country:US
Mailing Address - Phone:218-741-4714
Mailing Address - Fax:218-741-3080
Practice Address - Street 1:504 1ST ST N
Practice Address - Street 2:RANGE MENTAL HEALTH CENTER BELL BUILDING
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792
Practice Address - Country:US
Practice Address - Phone:218-741-4714
Practice Address - Fax:218-741-3080
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN49991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical