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Individual

MS. AMY FAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
1120 LARAMIE DR, BISMARCK, ND 58504-6373
(701) 222-2598
Mailing address
PO BOX 1995, BISMARCK, ND 58502-1995
(701) 222-2598

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
3281
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27507
BLUECROSS/BLUESHIELD
ND
05
74005
ND
Enumeration date
02/12/2008
Last updated
02/12/2008
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