Individual
MS. JESSICA WURTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4530 NORTHERN SKY DR, BISMARCK, ND 58503-8534
(701) 751-6336
(701) 751-6337
Mailing address
4530 NORTHERN SKY DR, BISMARCK, ND 58503-8534
(701) 751-6336
(701) 751-6337
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4448
ND
1041C0700X
Clinical Social Worker
Primary
4448
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74152
—
ND
Enumeration date
02/17/2011
Last updated
02/23/2022
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