Individual
JESUS ADALBERTO PAYAN CHACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAPC
Contact information
Practice address
515 E BROADWAY AVE, BISMARCK, ND 58501-4407
(701) 751-0443
Mailing address
515 E BROADWAY AVE, BISMARCK, ND 58501-4407
(701) 751-0443
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1376-7-1-24A
ND
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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