Organization
INTEGRATED INTERVENTION SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN MARTINSON (OWNER)
(701) 341-6025
Entity
Organization
Contact information
Practice address
4215 31ST AVE S STE A, FARGO, ND 58104-7743
(701) 478-0221
(701) 478-0222
Mailing address
4215 31ST AVE S STE A, FARGO, ND 58104-7743
(701) 478-0221
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538310792
—
ND
Enumeration date
06/21/2019
Last updated
02/01/2025
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