Individual
THERESA E SCULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
125 MAIN ST; UNIT 220, WILLISTON, ND 58801
(701) 570-4602
Mailing address
125 MAIN ST UNIT 220, WILLISTON, ND 58801-6030
(701) 570-4602
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4970
ND
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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