Individual
BECKA ANNE KOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
200 2ND AVE NW, MANDAN, ND 58554-3124
(701) 667-3281
Mailing address
200 2ND AVE NW, MANDAN, ND 58554-3124
(701) 667-3281
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5103
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104100000X
—
ND
Enumeration date
01/23/2019
Last updated
01/23/2019
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