Individual
TY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.A.C.
Contact information
Practice address
304 7TH ST N, NEW TOWN, ND 58763
(701) 627-4700
Mailing address
404 FRONTAGE RD, NEW TOWN, ND 58763-9404
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1779
ND
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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