Individual
MRS. CASSIE MARIE KASOWSKI I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1202 23RD ST S, FARGO, ND 58103
(701) 293-5429
Mailing address
1202 23RD ST S, FARGO, ND 58103-2951
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1053821090
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1824
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053821090
LADC
MN
01
—
1824
SUBSTANCE ABUSE
ND
Enumeration date
10/04/2017
Last updated
07/25/2018
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