Individual
ORVILLE S MANDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
4227 9TH AVE SW, FARGO, ND 58103-2018
(701) 282-6561
(701) 277-0306
Mailing address
4227 9TH AVE SW, FARGO, ND 58103-2018
(701) 282-6561
(701) 277-0306
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1409
ND
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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