Individual
PATRICIA SUE TALLAKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
808 3RD AVE S STE 303, FARGO, ND 58103-1865
(701) 364-4040
Mailing address
808 3RD AVE S STE 303, FARGO, ND 58103-1865
(701) 364-4040
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
510-6-15-04
ND
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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