Individual
MRS. RHEA KRISTINE WAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
921 2ND AVE S, FARGO, ND 58103-1705
(701) 361-9922
(701) 829-7140
Mailing address
921 2ND AVE S, FARGO, ND 58103-1705
(701) 361-9922
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
WAH-87-4552
ND
175T00000X
Peer Specialist
Primary
00000
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172A00000X
—
ND
05
—
175T00000X
—
ND
Enumeration date
02/09/2023
Last updated
02/09/2023
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