Individual
AMY HAUGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
511 2ND ST W STE B, WILLISTON, ND 58801-5907
(701) 580-7675
Mailing address
511 2ND ST W STE B, WILLISTON, ND 58801-5907
(701) 580-7675
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4108
ND
171M00000X
Case Manager/Care Coordinator
4108
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79333
—
ND
Enumeration date
05/15/2014
Last updated
09/12/2022
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