Individual
MAI MARDEA MERCHANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1574 68TH AVE S, FARGO, ND 58104-3005
(701) 730-3036
Mailing address
1574 68TH AVE S, FARGO, ND 58104-3005
(701) 730-3036
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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