Individual
MS. LESLIE A ROWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2100 SOUTH COLUMBIA ROAD, SUITE 202, GRAND FORKS, ND 58201
(701) 772-1588
(701) 746-6077
Mailing address
2100 SOUTH COLUMBIA ROAD, SUITE 202, GRAND FORKS, ND 58201
(701) 772-1588
(701) 746-6077
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
348
ND
103TC0700X
Clinical Psychologist
348
ND
103TM1800X
Intellectual & Developmental Disabilities Psychologist
348
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11758
—
ND
01
—
22997
BCBSND
ND
01
—
356J7RO
BCBSMN
MN
05
—
408918900
—
MN
01
—
A006
TRICARE
ND
Enumeration date
09/26/2006
Last updated
11/03/2014
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