Individual
LUCAS MITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
7151 15TH ST S, FARGO, ND 58104-6613
(701) 237-3123
(701) 237-4063
Mailing address
PO BOX 5007, MINOT, ND 58702-5007
(701) 237-3123
(701) 237-4063
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5131
ND
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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