Organization
DAKOTA SOUTHWESTERN WELLNESS, P. L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA KATHRYN WALLER LICSW, DCSW, LAC (AUTHORIZED OFFICIAL)
(701) 279-6981
Entity
Organization
Contact information
Practice address
606 4TH ST SW, BOWMAN, ND 58623-4527
(701) 523-6985
(701) 279-7185
Mailing address
PO BOX 475, BOWMAN, ND 58623-0475
(701) 279-6981
(701) 279-7185
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/16/2016
Last updated
09/16/2016
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