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Individual

ALYSSON MICHELLE THEWES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
139 3RD ST W, DICKINSON, ND 58601-5147
(406) 991-1475
Mailing address
PO BOX 522, SOUTH HEART, ND 58655-0025

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
50732
MT
1041C0700X
Clinical Social Worker
Primary
6662
ND
1041C0700X
Clinical Social Worker
8278-C
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101YM0800X
OR
Enumeration date
11/24/2014
Last updated
04/01/2024
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