Individual
MRS. LISA M FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LICSW
Contact information
Practice address
1020 36TH ST S STE C, FARGO, ND 58103-2237
(701) 297-7540
Mailing address
1020 36TH ST S STE C, FARGO, ND 58103-2237
(701) 297-7540
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1825
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19122
—
ND
Enumeration date
09/28/2006
Last updated
09/26/2024
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