Individual
TANYA HEUTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
905 E INTERSTATE AVE, BISMARCK, ND 58503-0549
(701) 222-4673
Mailing address
905 E INTERSTATE AVE, BISMARCK, ND 58503-0549
(701) 222-4673
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1913
ND
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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