Organization
AUTHENTICALLY YOU THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GABRIELLE ELISE HAGEN MS, LPCC (THERAPIST)
(701) 318-0895
Entity
Organization
Contact information
Practice address
3212 14TH AVE S STE 7, FARGO, ND 58103-6306
(701) 318-0895
Mailing address
4707 46TH ST S APT 315, FARGO, ND 58104-9014
(701) 318-0895
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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