Individual
MS. REBECCA M KOPP DUNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6046 14TH ST S, FARGO, ND 58104-7340
(701) 404-0997
(701) 566-8876
Mailing address
6046 14TH ST S, FARGO, ND 58104-7340
(701) 404-0997
(701) 566-8876
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20001
MN
Other
Enumeration date
12/14/2009
Last updated
10/05/2021
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