Individual
KATERI LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 S 4TH ST STE 201, GRAND FORKS, ND 58201-4715
(701) 787-8540
Mailing address
PO BOX 5196, GRAND FORKS, ND 58206-5196
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4862
ND
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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