Individual
MISS CHARLYNE K WALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED LAC
Contact information
Practice address
1202 23 ST S, FARGO, ND 58103
(701) 293-0736
(701) 293-5429
Mailing address
1202 23 ST S, FARGO, ND 58103
(701) 293-5429
(701) 293-0736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
ND
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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