Individual
LORI IBACETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
128 2ND AVE SE, DICKINSON, ND 58601-5623
(701) 495-8351
Mailing address
128 2ND AVE SE, DICKINSON, ND 58601-5623
(701) 495-8351
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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