Individual
TIFFANY MARIE CLOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
603 5TH ST NE, ROLLA, ND 58367-7329
(701) 370-2208
Mailing address
PO BOX 303, ROLLA, ND 58367-0303
(701) 370-2208
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3943
ND
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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