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Organization
SANFORD MEDICAL CENTER FARGO
Active
Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Professional Building
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA LECLERC (VICE PRESIDENT)
(701) 234-6248
Entity
Organization
Contact information
Practice address
100 4TH ST S, FARGO, ND 58103-1929
(701) 234-3100
Mailing address
100 4TH ST S, FARGO, ND 58103-1929
(701) 234-3100
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
08/18/2011
Last updated
11/27/2023
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