Individual
KRISTINA DIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 E BROADWAY AVE, BISMARCK, ND 58501-4742
(701) 323-5626
Mailing address
1800 E BROADWAY AVE, BISMARCK, ND 58501-4742
(701) 323-5626
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5066
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473799
—
ND
Enumeration date
06/22/2021
Last updated
06/22/2021
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