Individual
BRENDA MONIQUE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 S 4TH ST STE 401, GRAND FORKS, ND 58201-4715
(701) 795-3084
(701) 795-3050
Mailing address
151 S 4TH ST STE 401, GRAND FORKS, ND 58201-4715
(701) 795-3084
(701) 795-3050
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
247200000X
Other Technician
Primary
—
ND
Other
Enumeration date
01/20/2023
Last updated
01/20/2023
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