Individual
TIFFANY STUCKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
316 2ND AVE W, WILLISTON, ND 58801-5218
(701) 774-4600
(701) 774-4620
Mailing address
PO BOX 1266, WILLISTON, ND 58802-1266
(701) 774-4600
(701) 774-4620
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1787
ND
Other
Enumeration date
04/13/2016
Last updated
04/13/2016
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