Individual
MR. TIM J GIENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501-1208
(701) 328-8888
(701) 328-8900
Mailing address
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501-1208
(701) 328-8888
(701) 328-8900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3637
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19161
—
ND
01
—
26592
BLUE CROSS BLUE SHIELD ND
ND
Enumeration date
03/28/2006
Last updated
05/13/2009
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