Individual
REBECCA D EISSINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103
(701) 364-3300
(701) 364-8906
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 356-8801
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
4353
ND
1041C0700X
Clinical Social Worker
Primary
4353
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74154
—
ND
Enumeration date
02/09/2011
Last updated
07/19/2018
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