Individual
BRUCE L CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
101 E BROADWAY AVE, BISMARCK, ND 58501
(701) 222-0386
Mailing address
101 E BROADWAY AVE, BISMARCK, ND 58501
(701) 222-0386
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1279
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25264
BLUE CROSS BLUE SHIELD
ND
Enumeration date
01/26/2007
Last updated
07/08/2007
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