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Individual

WILLIAM D BRINK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
510 4TH ST S, FARGO, ND 58103-1914
(701) 476-7200
(701) 476-7261
Mailing address
510 4TH ST S, FARGO, ND 58103-1914
(701) 476-7200
(701) 476-7261

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1145
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26066
BCBS-ND
ND
01
412781009810
PREFERRED ONE
Enumeration date
07/25/2007
Last updated
07/25/2007
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