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Organization
CARITA R SHAWCHUCK PHD PC
Active
Organization
CARITA R SHAWCHUCK PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARITA RENEE SHAWCHUCK PH.D. (PRESIDENT)
(701) 893-3419
Entity
Organization
Contact information
Practice address
1351 PAGE DR S, SUITE 105, FARGO, ND 58103-3502
(701) 893-3419
(701) 356-8801
Mailing address
1351 PAGE DR S, SUITE 105, FARGO, ND 58103-3502
(701) 893-3419
(701) 356-8801
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
01/03/2007
Last updated
12/12/2007
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