| NPI | 1114516234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MARIE HAM Counselor 701-751-1545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2023-10-24 |