| Sanford Professional Building | |
|
100 4th St S Fargo ND 58103-1929 | |
| (701) 234-3100 | |
| Not Available |
| Full Name | Sanford Professional Building |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 100 4th St S, Fargo, North Dakota |
| Authorized Official Name and Position | Martha Leclerc (VICE PRESIDENT) |
| Authorized Official Contact | 7012346248 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanford Professional Building 100 4th St S Fargo ND 58103-1929 Ph: (701) 234-3100 | Sanford Professional Building 100 4th St S Fargo ND 58103-1929 Ph: (701) 234-3100 |
| NPI Number | 1962782268 |
|---|---|
| Provider Enumeration Date | 08/18/2011 |
| Last Update Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962782268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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