| Peak Pathways Pc | |
|
3523 45th St S Fargo ND 58104-8962 | |
| (701) 941-0175 | |
| (701) 941-3001 |
| Full Name | Peak Pathways Pc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3523 45th St S, Fargo, North Dakota |
| Authorized Official Name and Position | Vicki Susan Burgess (PRIMARY) |
| Authorized Official Contact | 7019410175 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peak Pathways Pc 4160 24th Ave S Ste 102 Fargo ND 58104-9038 Ph: (701) 941-0175 | Peak Pathways Pc 3523 45th St S Fargo ND 58104-8962 Ph: (701) 941-0175 |
| NPI Number | 1144094459 |
|---|---|
| Provider Enumeration Date | 11/08/2023 |
| Last Update Date | 11/08/2023 |
| Certification Date | 11/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144094459 | NPI | - | NPPES |
| 113561521545 | Other | ND | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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