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Individual

MRS. AIDA BADRAN WAKEFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
600 DEMERS AVE STE 301, GRAND FORKS, ND 58201-4599
(701) 746-9341
(701) 746-1136
Mailing address
600 DEMERS AVE STE 301, GRAND FORKS, ND 58201-4599
(701) 746-9341
(701) 746-1136

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
995
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
19143
ND
01
5G324WA
BCBS MN
MN
01
6257044
UBH
01
A006
WPS
01
BAD24778
BCBS ND
ND
Enumeration date
07/19/2006
Last updated
07/09/2007
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