Tupa Therapy Pllc | |
1330 Page Dr S Fargo ND 58103-3500 | |
(701) 478-6604 | |
Not Available |
Full Name | Tupa Therapy Pllc |
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Speciality | Social Worker |
Location | 1330 Page Dr S, Fargo, North Dakota |
Authorized Official Name and Position | Heidi Tupa (LICENSED CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 7018702677 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tupa Therapy Pllc 1330 Page Dr S Fargo ND 58103-3500 Ph: () - | Tupa Therapy Pllc 1330 Page Dr S Fargo ND 58103-3500 Ph: (701) 478-6604 |
NPI Number | 1518614981 |
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Provider Enumeration Date | 03/07/2022 |
Last Update Date | 03/07/2022 |
Certification Date | 03/07/2022 |
Medicare PECOS PAC ID | 5294116935 |
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Medicare Enrollment ID | O20220713000809 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518614981 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Heidi Tupa |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1093461840 PECOS PAC ID: 0648651380 Enrollment ID: I20220719003671 |
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