Individual
GAYLENE MITTLEIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 4TH ST S, CARRINGTON, ND 58421-1967
(701) 652-1354
Mailing address
1025 4TH ST S, CARRINGTON, ND 58421-1967
(170) 165-2135
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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