Organization
WILDFLOWER MENTAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA KOUBA LCSW (OWNER)
(701) 699-4052
Entity
Organization
Contact information
Practice address
919 S 7TH ST STE 401, BISMARCK, ND 58504-5835
(701) 751-1579
(701) 401-0115
Mailing address
919 S 7TH ST STE 401, BISMARCK, ND 58504-5835
(701) 751-1579
(701) 401-0115
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/10/2023
Last updated
02/27/2024
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