Individual
MISTY IBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC, LPCC
Contact information
Practice address
1202 23RD ST S, FARGO, ND 58103-2951
(701) 293-5429
(701) 293-0736
Mailing address
1202 23RD ST S, FARGO, ND 58103-2951
(701) 293-5429
(701) 293-0736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1783
ND
101YM0800X
Mental Health Counselor
Primary
775-3-1-14-430
ND
Other
Enumeration date
08/20/2015
Last updated
05/03/2022
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