Individual
MYSTE JO NELSEN HUTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
340 DIVISION AVE, GRAND FORKS, ND 58201-4702
(218) 791-9539
Mailing address
2607 OLIVE ST, GRAND FORKS, ND 58201-7054
(218) 791-5935
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5460
ND
1041C0700X
Clinical Social Worker
135587
IA
1041C0700X
Clinical Social Worker
29796
MN
Other
Enumeration date
03/13/2018
Last updated
12/16/2025
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