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Individual

ROBERTA J PYTLIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC, LPCC

Contact information

Practice address
17 7TH ST S, FARGO, ND 58103-1800
(701) 478-1221
Mailing address
6211 57TH AVE S, FARGO, ND 58104-5720
(701) 793-5400

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1659
ND
101YP2500X
Professional Counselor
873-4-15-16-365
ND

Other

Enumeration date
09/20/2011
Last updated
11/01/2019
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