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Individual

MRS. BRENDA JO ERIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
448 21ST ST W STE D1, THERAPY SOLUTIONS, DICKINSON, ND 58601-2647
(701) 483-1000
(701) 483-1001
Mailing address
448 21ST ST W STE D-1, THERAPY SOLUTIONS, DICKINSON, ND 58601-3462
(701) 483-1000
(701) 483-1001

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2668
ND
1041S0200X
School Social Worker
2668
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4560002242
ND
Enumeration date
08/30/2010
Last updated
06/22/2011
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