Individual
SANDRA RISTAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1405 LIBRARY CIR, GRAND FORKS, ND 58201-6317
(701) 330-8552
Mailing address
1405 LIBRARY CIR, GRAND FORKS, ND 58201-6317
(701) 330-8552
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
ND
172A00000X
Driver
—
ND
174400000X
Specialist
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171M00000X
—
ND
Enumeration date
12/28/2020
Last updated
04/01/2024
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