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Individual

JESSICA MARIE MERTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
7151 15TH ST S, FARGO, ND 58104-6613
(701) 364-2950
(701) 364-2953
Mailing address
7151 15TH ST S, FARGO, ND 58104-6613
(701) 364-2950
(701) 364-2953

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4490
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4490
LICENSE
ND
Enumeration date
01/11/2012
Last updated
10/04/2023
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