| Carita R Shawchuck Phd Pc | |
|
1351 Page Dr S Suite 105 Fargo ND 58103-3502 | |
| (701) 893-3419 | |
| (701) 356-8801 |
| Full Name | Carita R Shawchuck Phd Pc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 1351 Page Dr S, Fargo, North Dakota |
| Authorized Official Name and Position | Carita Renee Shawchuck (PRESIDENT) |
| Authorized Official Contact | 7018933419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carita R Shawchuck Phd Pc 1351 Page Dr S Suite 105 Fargo ND 58103-3502 Ph: (701) 893-3419 | Carita R Shawchuck Phd Pc 1351 Page Dr S Suite 105 Fargo ND 58103-3502 Ph: (701) 893-3419 |
| NPI Number | 1871650267 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 12/12/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871650267 | NPI | - | NPPES |
| 06753001 | Other | ND | ND BLUE SHIELD |
| 86G13SH | Other | MN | MN BLUE SHEILD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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