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Individual

ELLEN GUGISBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED

Contact information

Practice address
1201 25TH ST S, FARGO, ND 58103-2311
(701) 451-4900
(701) 451-5057
Mailing address
2634 SUNGATE DR S, FARGO, ND 58103-3555

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17979
BCBSND
MN
01
2040318
CIGNA
ND
01
2352431
AMERICA'S PPO
MN
01
309S8GU
BCBSMN
MN
01
58103-A004
TRIWEST
ND
01
62-87355
MEDICA UBH
ND
01
9397797
PHCS
ND
01
HP70690
HEALTH PARTNERS
ND
Enumeration date
02/21/2007
Last updated
07/08/2007
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