Organization
MINDFUL BALANCE THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY KLOBUCHAR LCSW (OWNER/THERAPIST)
(701) 922-0857
Entity
Organization
Contact information
Practice address
3175 SIENNA DR S STE 101, FARGO, ND 58104-8910
(701) 922-0857
Mailing address
3175 SIENNA DR S, FARGO, ND 58104-8910
(701) 922-0857
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/11/2023
Last updated
08/21/2023
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