Individual
KIM SPICZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1351 PAGE DR S STE 301, FARGO, ND 58103-3536
(701) 205-4533
(701) 205-4593
Mailing address
1351 PAGE DR S STE 301, FARGO, ND 58103-3536
(701) 205-4533
(701) 205-4593
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
811-12-1-14-296
ND
101YP2500X
Professional Counselor
811-12-1-14A
ND
Other
Enumeration date
12/23/2014
Last updated
10/27/2021
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