STEPHEN E ILLING

FARGO, ND
NPI1255348991
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ND  1059)
Enumeration Date2006-08-02
Last Update Date2007-07-08
Business Address
-- STEPHEN E ILLING LAC
2624 9TH AVE S
FARGO, ND 58103-2350
Phone number: 701-298-4500
Mailing Address
-- STEPHEN E ILLING LAC
2624 9TH AVE S
FARGO, ND 58103-2350
Phone number: 701-298-4500
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