Individual
LAVONNE LAURA GULLICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
411 S MAIN ST, BENEDICT, ND 58716
(701) 679-2121
Mailing address
PO BOX 188, BENEDICT, ND 58716-0188
(701) 679-2121
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
ND
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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