Individual
CHERYL ELLEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
720 4TH ST N, FARGO, ND 58122-0001
(701) 234-6486
Mailing address
PO BOX 2010, FARGO, ND 58122-0001
(701) 234-6486
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
25806
MN
1041C0700X
Clinical Social Worker
Primary
3518
ND
Other
Enumeration date
10/31/2016
Last updated
10/31/2016
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