Individual
PHALLA KATRINA SEUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1136 22ND ST S, FARGO, ND 58103-2995
(701) 200-0964
Mailing address
1136 22ND ST S, FARGO, ND 58103-2995
(701) 200-0964
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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