Individual
TAMARA MARIE MADLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LAC, LICSW
Contact information
Practice address
1351 PAGE DR S STE 201, FARGO, ND 58103-3536
(701) 203-9013
(855) 938-2249
Mailing address
1351 PAGE DR S STE 201, FARGO, ND 58103-3536
(701) 203-9013
(855) 938-8229
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3137
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19151
—
ND
05
—
893674100
—
MN
Enumeration date
12/18/2006
Last updated
09/19/2023
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