Individual
MS. KATHY MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2000
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
732
ND
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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