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1023054210
SUE A MOCK
BISMARCK, ND
NPI
1023054210
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ND 1307)
Enumeration Date
2006-06-22
Last Update Date
2007-07-08
Business Address
-- SUE A MOCK LAC
1237 W DIVIDE AVE STE 5
BISMARCK, ND 58501-1208
Phone number: 701-328-8763
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Mailing Address
-- SUE A MOCK LAC
1237 W DIVIDE AVE STE 5
BISMARCK, ND 58501-1208
Phone number: 701-328-8763
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