Individual
MELISSA FAE NYSTUEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
316 2ND AVE WEST, WILLISTON, ND 58801
(701) 774-4600
(701) 774-4620
Mailing address
PO BOX 1266, 316 2ND AVE WEST, WILLISTON, ND 58802-1266
(701) 774-4600
(701) 774-4620
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4400
ND
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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