Individual
STEPHANIE HOMSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 S 4TH ST, SUITE 201, GRAND FORKS, ND 58201-4715
(701) 787-8568
(701) 787-5918
Mailing address
151 S 4TH ST, SUITE 201, GRAND FORKS, ND 58201-4715
(701) 787-8568
(701) 787-5918
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4207
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79359
—
ND
Enumeration date
04/21/2014
Last updated
04/21/2014
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