Individual
MRS. MARONDA ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1202 23 ST S, FARGO, ND 58103
(701) 293-5429
(701) 293-0736
Mailing address
1202 23 ST S, FARGO, ND 58103
(701) 293-5429
(701) 293-0736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3002
—
ND
Enumeration date
10/10/2007
Last updated
10/10/2007
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