Individual
CHRISTI LYNN SHADOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
516 COOPER AVE FL 2, GRAFTON, ND 58237-1512
(701) 352-5129
(701) 352-5060
Mailing address
516 COOPER AVE FL 2, GRAFTON, ND 58237-1512
(701) 352-5129
(701) 352-5060
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3689
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79192
—
ND
Enumeration date
12/10/2013
Last updated
12/10/2013
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