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1811274038
JEREMY TRAEN
FARGO, ND
NPI
1811274038
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: ND 1664)
Enumeration Date
2011-11-16
Last Update Date
2012-01-10
Business Address
JEREMY TRAEN LAC
505 40TH ST S UNIT B
FARGO, ND 58103-1184
Phone number: 701-478-8440
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Mailing Address
JEREMY TRAEN LAC
1121 2ND AVE S APT 18
MOORHEAD, MN 56560-2979
Phone number: 218-233-6398
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