Organization
MARY J SOLBERG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAR HICKEL (OFFICE MANAGER)
(701) 839-0474
Entity
Organization
Contact information
Practice address
1705 4TH AVE NW, MINOT, ND 58703
(701) 839-0474
(701) 839-0713
Mailing address
1705 4TH AVE NW, MINOT, ND 58703-2912
(701) 839-0474
(701) 839-0713
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2997
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19302
—
ND
01
—
717658
MEDICARE PTAN
ND
01
—
N717658
MEDICARE PTAN
ND
Enumeration date
04/23/2014
Last updated
05/15/2014
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