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Organization
PRAIRIER ST JOHN'S
Active
Organization
PRAIRIER ST JOHN'S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER HOWARD (CEO)
(701) 476-7863
Entity
Organization
Contact information
Practice address
510 4TH ST S, FARGO, ND 58103-1914
(710) 476-7863
(615) 312-5711
Mailing address
510 4TH ST S, FARGO, ND 58103-1914
(710) 476-7863
(615) 312-5711
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
2084P0800X
Psychiatry Physician
—
ND
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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