| NPI | 1962782268 |
|---|---|
| Doing Business As | SANFORD PROFESSIONAL BUILDING |
| Entity Type | Organization |
| Authorized Contact | MARTHA LECLERC Vice President 701-234-6248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2023-11-27 |