Organization
MINDFUL RIVER PSYCHOTHERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE VAUGHN LCSW, LICSW (OWNER)
(785) 323-7653
Entity
Organization
Contact information
Practice address
808 3RD AVE S STE 204, FARGO, ND 58103-1865
(785) 232-7653
Mailing address
808 3RD AVE S STE 204, FARGO, ND 58103-1865
(785) 232-7653
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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