Individual
MRS. TARA L SHIREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
735 HILL AVE, SUITE 203, GRAFTON, ND 58237
(701) 746-8376
(701) 746-9872
Mailing address
2808 17TH AVE S, GRAND FORKS, ND 58201-4010
(701) 746-8376
(701) 746-9872
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2922
ND
1041C0700X
Clinical Social Worker
2922
ND
1041C0700X
Clinical Social Worker
Primary
2922
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1456289
—
ND
Enumeration date
05/25/2007
Last updated
04/20/2016
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