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Individual

TRICIA C MYERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4111
(701) 234-4130
Mailing address
100 4TH ST S, FARGO, ND 58103-1929
(701) 234-4111
(701) 234-4130

Taxonomy

Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
Primary
342
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11275
ND
05
872930100
MN
Enumeration date
07/17/2006
Last updated
11/12/2008
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