| Child And Family Therapy Associates | |
|
1121 Westrac Dr S Ste 204 Fargo ND 58103-2385 | |
| (701) 893-3419 | |
| (701) 356-8801 |
| Full Name | Child And Family Therapy Associates |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 1121 Westrac Dr S Ste 204, Fargo, North Dakota |
| Authorized Official Name and Position | Carita R Shawchuck (OWNER) |
| Authorized Official Contact | 7018933419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child And Family Therapy Associates 1121 Westrac Dr S Ste 204 Fargo ND 58103-2385 Ph: (701) 893-3419 | Child And Family Therapy Associates 1121 Westrac Dr S Ste 204 Fargo ND 58103-2385 Ph: (701) 893-3419 |
| NPI Number | 1013269257 |
|---|---|
| Provider Enumeration Date | 10/12/2012 |
| Last Update Date | 10/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013269257 | NPI | - | NPPES |
| 11062 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 295 (North Dakota) | Primary |
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