Individual
MRS. AMANDA JEAN KOUBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
919 S 7TH ST STE 401, BISMARCK, ND 58504-5835
(000) 000-0000
Mailing address
2401 46TH AVE SE STE 201, MANDAN, ND 58554-4829
(701) 699-4052
(701) 989-7030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5156
ND
Other
Enumeration date
09/29/2017
Last updated
11/15/2023
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