Individual
KIAH G STALOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-8000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP6386
MN
Other
Enumeration date
08/21/2015
Last updated
06/24/2021
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