Individual
JASON GRABAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
510 4TH ST S, FARGO, ND 58103-1914
(701) 476-7200
Mailing address
510 4TH ST S, FARGO, ND 58103-1914
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1733
ND
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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