Individual
PURNA BAHADUR GHALLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 42ND ST S APT 324, FARGO, ND 58103-2162
(701) 541-6972
Mailing address
901 42ND ST S APT 324, FARGO, ND 58103-2162
(701) 541-6972
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
GHA-01-4037
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GHA-01-4037
—
ND
Enumeration date
03/31/2022
Last updated
03/31/2022
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