Individual
IFRAH BASHI LAITOUSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1323 23RD ST S STE D, FARGO, ND 58103-3759
(701) 320-2102
Mailing address
1323 23RD ST S STE D, FARGO, ND 58103-3759
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/06/2023
Last updated
07/17/2025
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