Individual
MS. JANELLE R MIEDEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1202 23 ST S, FARGO, ND 58103
(701) 293-5429
(701) 293-0736
Mailing address
1202 23 ST S, FARGO, ND 58103
(701) 293-0736
(701) 293-0736
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
992
ND
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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